NCG140180_MONITORING INFO_20190130

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v
DOC TYPE
❑HISTORICAL FILE
3,,4MONITORING REPORTS
DOC DATE
❑ 00 11 U 1 3 U
YYYYMMDD

Mid Atlantic
Engineering & Environmental Solutions
January 22, 2019
409 Rogers View Court
Raleigh. NC 2 76 10
office 919.250.9918
facsimile 919.250.9950
MAAONLINE.COM
NC Department of Environmental Quality
Division of Water Resources
R�G�ill�T
Attn: DWR Central Files
3AN ZU1�
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
CENTRAL FILES
DWR SECTION
Subject: ANNUAL SUMMARY DISCHARGE MONITORING REPORT
NOTIFICATION OF NON -SAMPLING
CONCRETE SERVICE COMPANY PLANT NO. 16
393 RANKIN STREET
FAYETTEVILLE, CUMBERLAND COUNTY, NORTH CAROLINA
NPDES PERMIT NO. NCG140180
MID -ATLANTIC JOB NO. OOOR1944.10
To Whom It May Concern:
On behalf of Concrete Service Company, Inc., this letter serves as notification that a stormwater
sample was not collected during the previous calendar year (2018). During this timeframe, it is
our understanding that a stormwater discharge did not occur from the designated site outfall
during a measurable storm event at a time when a stormwater sample could be safely collected
(i.e. during business hours when the facility was occupied, and preceded by 72 hours with no
measurable storm event). Stormwater flow will continue to be monitored during the upcoming
monitoring periods (January -June and July -December 2019) and, in the event of a discharge,
stormwater samples will be collected per the permit requirements. If you have any questions or
need additional information, please contact me at 919-250-9918.
Sincerely,
MID -ATLANTIC ASSOCIATES, INC.
Charles B. Hoffman, P.G.
Principal Geologist
Attachment: Annual Summary Discharge Monitoring Report
EXPERIENCED CUSTOMER FOCUSED INNOVATIVE

ANNUAL SUMMARY DISCHARGE MONITORING REPORT
(DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year 2018
*Report ALL STORMWATER monitoring data on this form (include "No Flow"/"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG14
Facility Name:
Service Company Plant #16
County
Phone Number: (�
SDOs monitored
Certified Laboratory
1
Concrete
Cumberland
910237-1791
Lab # Pace Analytical Services, Inc. 12
Lab #
Stormwater Discharge Outfall (SDO) No. VMA Outfall? Yes 1 ❑ No
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No
Was this outfall ever in Tier 2 during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, was monthly monitoring discontiued?
Yes, enough consecutive samples below benchmarks to decrease frequency 13
Yes, received approval from DEMLR to reduce monitoring frequency
Other
Total no. of
Non -polar O&G
Total
pH,
(EPA Method
New Motor Oil
Total Rainfall,
Suspended
SU
1664 (SGT-HEM)),
Usage (gallmo.)
Outfall No.
inches
Solids (TSS),
mgll (VMA)
mgll
napplicable
napplicable
Stormwater
Circle Benchmark
Benchmarks
ladlcate NO FLOW s
100/50
A
6.0-9.0
}65 gallmo. average requires TSS and
applicable
15
Non -polar osGmonitoring
Date Sample
Collected,
molddlyr
06/30/2018
No Discharge
No Discharge
No Discharge
No Discharge
NIA (<55 gaVmo average)
12/31/2018
No Discharge
No Discharge
No Discharge
No Discharge
NIA (<55 gallmo average)

Permit Date 3/1/2017 — 6/30/2022
Last Revised 8-22-2015
Certificate of Coverage No. NCG 14 0 1 8 0
CERTIFICATION
"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, accate, and complete. I am aware that there are significant penalties for
submitting f l�e inforWtion, includ the possibility of fines and imprisonment for knowing violations."
(Requin
Signat
Date , 1)1q � M
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct— Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center Raleigh,
NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at: (919)
707-9220

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 O- J_ Q
FACILITY NAME: ns 'i
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY: Lab #
Lab #
LIMIT VIOLATIONS? YES ❑ NO ❑
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR:/r1 I
SAMPLE QUART&R: Jul-�S�ept Oct -Dec QJan-March ❑April -June
COUNTY:
PHONE NO.
ADD TO LISTSERVE? DYES ONO EMAIL: i
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO:
Outfatl No,
Date Sample
Collected'
(IM /dd/yr)
Type of Wastewater
(Vl; RM, MD) z
pH
(standard]
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1654.4
SGT
(mg/LJration
1L)
Discharge
Du
(minutes)
Total Flow
y
)gallons/day)
'
6 93a
303s
53
(15),
-
-
le
1,11-GE-1VED
TKAL i'tLE_
Ir
1 If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RK4), Mixing Drum
Cleanout (MD), Report more than one type if the waste -stream is commingled.
31f an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
pH limits are 5-9 S. U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and.PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-05/30/2015 Last Revised 07/13/11
Page 1 of 2
Date of last pH meter calibration:

!Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 028 .0224. Perrnittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. if the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual (low
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF TH15 ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERI.OD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
(9.19) 807-6379
YOU MUST SIGN THIS CER77FICATION 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 t there nificant penalties for submitting false information, including the possibility of fines and imprisonmentfor knowing
violati s.
;Signal a erm JDate)
Permit Date. 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14_Q 1 0
FACILITY NAME: BE*" K 2t lh
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY: Lab #
Lab #
LIMIT VIOLATIONS? YES ❑ NO ❑
'art A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: Zo/7
SAMPLE QUAR Jul -Sept ` []Oct -Dec []Jan -March ❑Ap
COUNTY: G►n f71
PHONE NO.
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Outer,
OPTIONAL INFO:
ril-June
abate Sample
Tyge'ofVYastevrater
pH
Total Stir ded
Settfeahle
TPH usm
n+ethad ib64A
Discharge
`total Flaw
Duttalf No'
Cnllettedl
(IiE, iiM, MDR
[standard)
Solids
Solids
`SGT-NE11
: Uuratton
7
(gallons/day)
(;rirg/Lj
: (m VLF
Smeiiutes j
(n�g/i
OW
T , -7
V
�. ,
C&NTRAL
FI
SECTION
Or
' If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Geanout (MD)_ Report more than one type if the waste -stream is commingled.
3 tf an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
C pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters_
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date:7/1/2010-06/30/2015
Last Revised 07/13/11
Page 1 of 2

a Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 020 .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE, WITHIN 30 DAYS OF RECEIPT OF SAMPLE (9
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW TO:
Division of Water Quality T
Attn: DWQCentral Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERTMFICATION FOR ANY INFORMATTON 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 r visible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. I am awar hat jore significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
I
Permit Date: 7/1/2010-06/30/2015
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER -- Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14� � a=
FACILITY NAME:
PERSON COLLECTING SAMPL S: r✓Ifi
CERTIFIED LABORATORY: Lab #
Lab #
LIMIT VIOLATIONS? YES ❑ NO ❑
'art A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2.0 C
SAMPLE QUARTER: Jul -Sept []Oct -Dec ❑Jan -March April -June
COUNTY;
PHONE NO. (-qLO q53- _90517
ADD TO USTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout []Other
OPTIONAL INFO:
:.^ oat Sahtpfe
:1
Cotletted::
;Type ofVYarsteiivater
_:?:;°pH ;;:`: '
::Tortall Siispe�iiled
Soliifs'°;:
Settleable
'
usrrr 4 ...::
method1s64A;
:Discharge.
,..-; ,,< :.::...:.Total
::.
Flow
0utfall No` :?
....::::.::::
(mm/dd/3rr
,_ z .:.
M .MD : <
- EVE, iR ,, .. }
....:. .. :.: . ::
:. standard
( .. i
,: `<
::
Solid;
im!/Lj`<;:::
:::
:::::: SGT-H1 A?G'::;:.
. Durattan:';
.::.:::::: .:..... .:
..:.... .. z
: (gallons/dal/
:.
is
a
- v
tt wastewater systems have not discharged In this quarter — report No Plow or No Discharge here. Please maKe sure to mark the sample quarter above.
z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
phl limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters,10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

e Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 020 .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW-, DISCHARGE-) WITHIN 30 DAYS OF RECEIPI_OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERTIFICATION FOR ANYI FORMATION 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,"t there are significant penalties for submitting: false information, including the possibility of fines and imprisonment for knowing
of Permitteej
Permit Date: 7/1/2010-06/30/2015
(te)
Last Revised 07/13/11
Page 2 of 2

i
PROCESS WASTEWATER -- Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVE GE NO. CG14_ 1 X b RCCEI !=E COLLECTION YEAR: ZO1 ?
FACILITY NAME: HC E QUARTER: Jul- pt []Oct -Dec O<Jan-March []April -June
PERSON COLLECTING SAMPLES: �f�- PR ]- OUNTY: �,,i w--
CERTIFIED LABORATORY: Lab #_ ,� rf�A_ PHONE NO. c a)o y ;- 1091
Lab # rC�A�jLD TO LISTSERVE? [:]YES []NO EMAIL:
LIMIT VIOLATIONS? YES ❑ NO ❑ ISIk' HARGING TO CLASS: [:]SA ❑HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO:
Part A: Wastewater Monitoring Requirements
I YY0SLC11v0LCl NybLul144 IlavC iluL unulalgru II I uIt3lAUell LC —I ICIJUI L l\u i-IUYN ul IYN iJjJLljot SC LtCl C. r1CaaC IIlaiLC �ulv L1J le[aim L!!C JaiIljjFU Dual LCi OLJVV r.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD)- Report more than one type if the waste -stream is commingled.
a if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
S TSS limits are 20 mg/L for wastewater discharges to HQW waters,10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

C"
Y
6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the tiered Response Action.
7 Flow rate can be measured continuously or calculated. flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 71110 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF, RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN TFUS CERTIFICATION FOR ANYWFORMATION 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
OF
of Permittee)
Permit Date:7/1/2010-06/30/2015
(Date)
Last Revised 07/13/11
Page 2 of 2

t<
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14p— 1, A D
FACILITY NAME: Igftab zea.Ii MIA,
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY: T Lab # Nil
Lab #
LIMIT VIOLATIONS? YES ❑ NO ❑
'art A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: _ ZalIQ
SAMPLE QUARTER: []Jul -Sept VOct-Dec []Jan -March ❑April -June
COUNTY• _ CrtAOnb9AGAJ
PHONE NO. i 4io 1 3- a r
ADD TO LISTSERVE? DYES O EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑RNA ❑Trout ❑Other
OPTIONAL INFO:
i
:...::- Date Sam fe
l?
L
:..::..::
: •::::=.:r:-:::.
:af.Wastewater::::
YAe.:..,
::; Ff .::•.
P
de :::
Siuspe+t.:d ..:.:' =:;::
k,
sable
Sett1 ....
:::.:..... .:.:.:::`: :
6imm 1S54A:
Discharge:
Total Flow
outfa: No. '?
._
:'`:'::: tollected>
::::..
.
<:...... _ z.,,.,;..:
=VE. RM,1Vlp}::.:::;
.
-::::::...:::;__:-_' :>:::::' ".:::::::-
{st nda
:;::.::.::°:::.;: sends ..::
.
Salids .<::?:
::: -
..
Durafion: -.
_ .::.: :
,
(gallons/daY}
:rmm/dd/1►r�
:.:.:.:.:.:... ..
;:::'.':.:SGT-FIEIv
. n1
6L
3'
6 -
-
_
REGLIVED
!i rs
DWR
SECTION -
f wastewater systems have not discharged in this quarter -- report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
Z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (V£), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD)- Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring-
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
S TSS limits are 20 mg/L for wastewater discharges to HQW waters,10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/i/2010-06/30/2015
Last Revised 07/13/11
Page i of 2

6 Frocess wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
J Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY {INCLUDING ALL "NO FLOW-. -NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PIERIOD IN CASE OF "NO FLOW-
J,TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERTIFICATION FOR ANYINFORMATION 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
(Date)
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER -- Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVE RA E NO. NCG14 D D
FACILITY NAME. OS
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY: Lab #
Lab #
LIMIT VIOLATIONS? YES ❑ NO
►art A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: ZO 116
SAMPLE QUARTER: Jul-S#pt QOct-Dec ❑Jan -March
COUNTY:. 011w6v _d
PHONE NO. L qU- PII
ADD TO USTSERVE? [:]YES O EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA OTrout ❑Other.
OPTIONAL INFO:
QApri!-June
DateSartt le?:Total
l?-
°. - :-_ ::. • . - L:
,.: =Type. lllfasteswate
±etltdtf I66gA: i
-
Total flow
= -
:,..:,,:-::;,:.:.
T-HE1V�:;.:.:.
i0uratton;,
�1/1
. � ...,...•...�..�, �.:........:.�..:.
{�!/dd/yr}
--.
<::. .::
.:.: � .:..[�Ily;`_===-:-=:< :�:�;:�:;;;.{m�i�_�:�.�:�
�:�:�::c: ��::�<::.;:_..:�,:::=: �.
1n L
-: imsnutesl_
-:-: .
..:.......
17
Q �l 1
Dam
ES
If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD)_ Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
a pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
s TSS limits are 20 mg/L for wastewater discharges to HQW waters,10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process�wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 026 .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW" "NO DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST S(GN THIS CERTIRC4TION FORA Y I FORMA ON 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 thgt there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
qholjo
{Da(e)
Permit Date: 7/l/2010-06/30/2015 last Revised 07/13/11
Page 2 of 2

a
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
It GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 C_ v _Lr b
FACILITY NAME, araos 91a91 Mox
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY: 44Lab#
Lab #
LIMIT VIOLATIONS? YES ❑ NO ❑
SAMPLE COLLUMON YEAR: 2011-P
SAMPLE.QUARUR: []Jul -Sept []Oct -Dec ❑Jan -March
COUNTY_ C'. ^locA4,J
PHONE NO. ( alto 1 q% 3 - jog2
ADD TO LISTSERVE? ❑YES ❑✓ NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trait
OPTIONAL INFO:
April -June
❑Other
Part A: Wastewater Monitoring Requirements
Date Sar tpte
_ . ::..:
...........:... ::.:.::...... .
Total:Suspe tiled
Settleable
Discharge
TOW Flow
ulfalr Na
"
:. (�E, >;wr ;::_:;;
:(standard}
;::.:.:
:.:. . .
l"
- ' ...:-- .....
JAI i :..
:. .Ma}
_ ... ....._......
�::�::>.:::��:::;.;>::::::.::.::::.:
::�:;�:�.':.°::;:=.Imsl��:�:�;::::::::::.:;::.::::1
�►In
m L
utesl::....:.-
,:....:.... .
6�::---
W
4,
i If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here_ Please make sure to mark the sample quarter above.
Z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD)_ Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the perm ittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
S T5S limits are 20 mg/L for wastewater discharges to HQW waters,10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-05/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NC$C 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY IIINCLUD_I_NG_ALL "NO FLOW", "NO DISCHARgE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW-) TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERiI OTION FOR ANY INFORMATION REPORTZ D:
"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 property 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
4 A
30
(Date)
Permit Date: 7/112010-06/30/2015 Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER— Quarterly Discharge Monitoring Report REORVEC
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14_i 1 0
FACILITY NAME:�aos�2 1
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY:_ - A)J 4 - Lab i#
A Lab #
LIMIT VIOLATIONS? YES ❑ NO
'art A: Wastewater Monitoring Requirements
APR 2 2 2016
DWt SECTION
SAMPLE COLLECTION YEAR: ZD 1 la INFORMATION PROCESSING UNIT
SAMPLE QUARTER: Jul -Sept OOct-Dec gJan-March
COUNTY: urnt9tan
PHONE NO. to y 3 09')
ADD TO LISTSERVE? OYES 2kO EMAIL:
DISCHARGING TO CLASS: ❑SA OHQW OPNA OTrout ❑Other.
OPTIONAL INFO. -
OApril-June
-
w4'
!
411
r
■■�
i\sue
_
■■■■■1■IlUn
1 If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
s TSS limits are 20 mg/L for wastewater discharges to HQW waters,10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

5 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
brut instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action,
T Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY [INCLUDING ALL "NO FLOW "NO DISCHARGE"] WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO;
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MU57SlGN THIS CEli1"iFlC4710N FOR ANYINFDRMATION 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 A I
(Signature
Permit Date: 7/V2010-06/30/2015
:� 31 / b
(Date}
Last Revised 07113/11
Page 2 of 2

.IN-
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140 ) � 0
FACILITY NAME: o,AM 1
PERSON cOLLECTIN6 swp wtu pbe,-
CERTIFIED LABORATORY: Lab #
Lab
LIMIT VIOLATIONS? YES ❑ NO ❑
Part A: Wastewater Monitorine Reauiretrients
SAMPLE COLLECTION YEAR: a o S-
SAMPLE QUARTER: []Jul -se JS0ct-Dec ❑!an-Mar❑e
ch 4M-Jun
COUNTY: C ombt ,L, _
PHONE NO. iO 3 •- 30
ADD TO USTSERVE7 []YES []NO EMAIL:
DISCHARGING TO CLASS: -❑SA ❑HQW ❑PNA [--]Trout Ootherk
OPTIONAL INFO:
r
1 If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleancut (MD). Report more than one type if the waste -strum is commingled.
3 if an effluent limit is exceeded twice in a row, the perrriittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
° pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6,".5 S.U_ for discharges to saltwaters_
5 TSS Limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/1-3/11
Page 1 of 2

'Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from vMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action-
7 Flow rate can be measured continuously or calculated- Flow limits for wastewater discharges to HQW waters shall be set to 50% of the 5ummer 7Q10 Flow as per 15A
NCAC 0213.0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. if the penmittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may rewire an annual flow
,,report on a case -by -case basis.
s � ,
MAIL ORIGINAL AND ON is COPY QF THIS WJIUAL SUMMARY ONQUIDING ALL "NO FLOW. `NO DI GE IN 30 DAYS OF RECEIPT OF OR
AT END OF MONFTORINfi PERIOD IN CASE OF "NO FLOW TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
(919)8D7-6379
YOU MUST—V li 7NHQ�TifJJIfMANY 11YA if 1EEKWTEII
All ceddy, render penatty of Law, that this document and all attad menu were prepared under my diretthm or supervision in acmrdanae with a system designed to
assure that qualified personnel property gather and evaluate the information submiitte& Based an my inquiry of the person or persons who manage the system, or
those persons directly resporuibie for gatherbw the 'information, the information submitted is, to the best of my knowtedge and bereef, true, accurate, and
complete. 1 am aerate that the are s4---r.fficant penalties for subFnh rkg false Information, Including the possibility of fines and imprisonment for knowing
violations
(Signature of Permittee)
Permit Date: 7/1/2010-06/30/2015
--- a- 3 / _ /V
(Date)
Last Revised 07/13/11
Page 2 of 2

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OCT 12 20RRO«S WASTEWATER — Quarterly Discharge Monitoring Report OCT I
CENTRAL FILES GENERAL PERMIT NO. NCG140M CEAir
DWR RAL FILE
DWR SECTION ECTIC: ■
CERTmCATE OF COVERAGE mo. NCG14 D 1 $ O
FACIUiY NAME;
PERSON COLLECTING SAMPLES:
CERR ED LABORATORY: Lab's
tab It
LIMIT VIOLATIONS? YES [] NO ❑
SAMPLE COLLECTION YEAR: Z O /S 93.
SAMPLE QU Oul-Sept []Od-0ec �lan-March []April-Jum=
COUNTY: Lim++ kg1c.iJ - Ge-31
PIIloNE No. c 410 S 4A3-10917
ADD TO uSTSERVE3 []YES ❑NO EMAIL If . ■
DM3MRGINGTO CLASS. E]SA ❑"Qw ❑PNA ❑Trout E]Mer___,..j
OPTIONAL INFQ"'
)art A: Wastewater Monitorieg it irernents
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vf= rtc ram.,..
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`#rf ax �s,. t'=" ,� ��,.•c-�,. x, �vjZ
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If wastewater systems have not discharged
irk this quarter— report "Na flow' or "No Disdharee" here. Please make sure to mark the sample quarter abnre_
' Report the abbreviation for the type of Authorized Wastewater Discharges here. Vehide and Equipment Cleaning (VE ), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MDj Report more than one type if the waste -stream is commingled.
3 it an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring,
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.84.5 S.U. for discharges to saltwaters.
s TSS limits are 20 mg/L for wastewater discharges to HQW waters,10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date. 7/1/2010-06/30/2015
Last Revised 07/13/11
Page 1 of 2
Mo.

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$ Process wastewater discharges shall only be monitored for TPH when commingled with stormwater dscharges frarn WA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A. ituluding the Tiered Response Action.
7 Flow rate can be measured continuously or calculated. Flow lirnits for wastewater discharges to HQW waters shall be set to 50% of the Summer TQID How as per 15A
NCAC 026.0224, Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow a nd report Oils information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
lui A% 26lG1NAL ANR ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL -NO FLOW. "NO DISCHARGE"} WITHIN 30 DAYS OF RECEIPT Of SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF `AIO FLDW" I TO:
Division of Water Quality
Attn: OWQCentral Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
M.ALU_5T5!FGX CER7 RC477ONFOR ANY nVORMAVON REPOR
"I certify, under penalty of Ilaw, first this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that quardled personnel property gather and evaluate the information submitted.. Based an my inquiry of the persons 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, trot, accurate, and
complete. I am aware that there are significant penalties for submitting false lnfonnation, including the possibility of fines and imprisonment for knowing
Permit Date: 7/112DIO.06/3012015
Q 3o /,S
(tee)
Last Revised 07/13/11
Page 2 of 2

'Iris 0 4
` r PROCESS WASTEWATER — Quarterly Discharge Monitoring RepofjECEI
GENERAL PERMIT NO. NCG140000 ED
CERTIFICATE OF COVERAGE NO. NCG14_()_LL0
FACILITY NAME: Rgaab _ m lc +-k _
PERSON COLLECTING SAMPLES: l�� sue.- v ^ Lf'.3
CERTIFIED LABORATORY: y Lab # 6L/1——
L%` ^ Lab ft Olt -
LIMIT VIOLATIONS? YES ❑ NO ❑
Part A: Wastewater Monitoring Requirements
All 1,3 2015 r+n
cipqTj�00000
SAMPLE COLLECTION YEAR: (90I S V+/
�ft Sjz . LES row
SAMPLE QUARTER: �Jul-Sept ❑Oct -Dec gian-March April -June
COUNTY: 0,,,ye � l4nJ eo
PHONE NO. J_qO ), 9 4" - °t 041__
ADD TO LIST5ERVE? []YES &NO EMAIL: ;`
DISCHARGING TO CLASS: ❑5A ❑HQW ❑ ❑ []Other Trout Other AIA- - wooOPTIONAL INFO:
Outfall No.
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
Z
(VE, RM, MD)
pH
(standard}
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1654A
S g/L) Is
(mg/L)
Discharge
Duration
(minutes)
Total Flow
,
(gallons/davl
-
-
-
6-93.4
303,5
53
(1515
-
-
i
1 If wastewater systems have not discharged in this quarter - report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
` Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RNi), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
31f an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
pH limits are 6-9 S. U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 T5S limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015
Last Revised 07/13/11
Page 1 of 2

l
a Process wastewat$r discharges shall only be monitored for TPN when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but insteadi sOtrject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate can be measured continuously or calculated. Flew limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q1D Flow as per 15A
NCACO2B.0224. Permittees who discharge wastewater to HQW waters shah obtain a Summer7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY LI UDING ALL "NO FLOW". -NO DISCHARGE-1 WITHIN 30 DRYS OF RECEIPT OF SAMPLE IDIt
AT END OF MONITORING PERIOD 1N CASE OF -NO FLOW") TO:
Division of Water Quality
Attn: DWQCentral Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
inu MUST SIGN THIS GERFf igTlON FOR MINFORMATION {€IcPORT1 D
al 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 evaluatethe information submitted. Based on my inquiry of the person or persons who manage ttie 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. 1 am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
violations."
(Signature of Permittee)
Permit Date: 7/112010-06/30/2015
5
(Dab')
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
X GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14_Q1, I U
FACILITY NAME: " Ir h n-ih !
PERSON COLLECTING SAMPLES: Afik�U JC9.kA1Cj
CERTIFIED LABORATORY. 414 _ Lab # &/*
,414 Lab # /7/4
LIMIT VIOLATIONS? YES ❑ NO
►art A.- Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: OI S
SAMPLE QUARTER: QJul-Sept [} ct-Dec Dian -march ril-June
COUNTY:
PHONE NO.
ADD TO LISTSERVE YES O EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA []Trout ❑Other
OPTIONAL INFO:
a
x-
i •I
11 VVdJ1C1IY01CI aYJLC111? IIdYC ItVL U13U1015— III LIIIJ 4-1-1 — 1 UP yr my 4.1J,.r m, 6c IIc, C• r I—. I-- JM.I ♦V ,i1Q1 n u - Jvr .1— arum ter vuvvG•
z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicie and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD)- Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saitwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date. 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater -discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
�,.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q20 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY MCULIPING ALL "NQ FLOW" "NO DISCHARGE" WITHIN 30 pAYS OF RECEIPT OF SAMPLE O R
AT END OF MONEQRI NQ PERIOD IN WE OF "NO FL
OW" TO:
Division of Water Quality
Attn: DWQCentral Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SfGN THIS CERTIFICATION FOR ANYINFfl{(MATJON REPOSED:
"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 possibllity c f Tines and imprisonment for knowing
violations."
j4co4tv'-
(Signature of Permittee) (Date)
Permit Date:7/l/2010-06/30/2015
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER -- Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCGI40000
CERTIFICATE OF COVERAGE NO, NCG14 OL JL Q
FACILITY NAME:
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY: _ /l Lab # J1IA
^Ae- _ Lab # t!R
LIMIT VIOLATIONS? YES ❑ NO ❑
Part A. Wastewater Monitorine Reauirements
SAMPLE COLLECTION YEAR: DIS' i
SAMPLE QUARTER: ❑Jul -Sept []Oct -Dec [].Ian -March NApril-June
COUNTY: �_,q)" Co:
PHONE NO.( 41/0 ) t/0- 0
ADD TO LISTSERVE7 ❑YES NO EMAIL: '
DISCHARGING TO CLASS: (_]SA ❑HQW ❑PNA [—]trout ❑Other
OPTIONAL INFO:
Outfall No.
Date Sample
Collected"
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD) x
pH
(standard)
Total Suspended
5ofids
(mg/L)
Settleable
Solids
(rnL/L)
TPH using
method 1664A
SG7 Hi:N
(R+6/LI
Discharge
Duration
(minutes)
Total Flow
7
(gallons/day)
-
6-934
303,5
53
CENTPj
kL FILES
kiv
DWR SECTION
All)
L t
I
1 If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3 if an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
° pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PHA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2
I

�f
6 Ffiocess wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 028.0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ, If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW" "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE _f —O-R
AT END OF MONITORING PERIOD IN CASE F "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUSTSIGN 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. 1 am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
(S
(D te)
Permit Date: 7/il/2010-06/30/2015 Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER —Quarterly. Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAG NO. NCG14C� `c Q
FACILITY NAME: on
PERSON COLLECTING SAM
CERTIFIED LABORATORY: 1.) Lab # il}!iE
nl A Lab #
LIMIT VIOLATIONS? YES ❑ NO ❑ IJ,4—
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION Y : r2 D Eq
SAMPLE QUARTER. Jul -Sept ❑Oct -Dec ❑Jan -March ❑April June
COUNTY: C,>.V L- sr,'.
PHONE NO. I _W ) 433 '?Oq7
ADD TO LSfSERVE? [-]YES []NO EMAIL:
DISCHARGING TO CLASS- -❑SA ❑HQW ❑PNA ❑Trout ❑OtherD —
OPTIONAL INFO:
, e
Type of Wastewater
1
r.
.7
1
�
s
1 If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here_ Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment weaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cieanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a roue, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring_
pH limits are 6-9 S.U. for wastewater discharges to freshwaters; and 6_".5 S.U_ for discharges to saltwatiers_
s TSS limits are 20 mg/1_ for wastewater discharges to HQW waters,10 mg/L for Trout and PNA waters, and 30 mg/L for all other water dassifications.
Permit Date: 7/1/2010-06/3U/201.5 Last Revised 07113/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions cf Part N, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits forwastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and reportthis information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the pennittee shall notify DWQ, and the i1WQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIG_IRAE AND ONE COPY OF THIS ANNUAL-S JMMARY IINaLLDINGALL `NO FLOW. "NO DISQHARGEI W[MIN 30.DAYS OF RECEIPT OF SAMPLE IOR
AT END OF MONITORING PERIOD IN CASE Of "NO FLOW 1 TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mall 5ervice Center
Raleigh, North Carolina 27699-1617
[phone]
r MUST 5FGN TM CERTAXATIMA111r _._.._
"I certify, under penalty of haw, that this document and all auadrments were prepared under my direcldvn or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evahu to the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the infomnation, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. I am aware that there are significant penatties for submitting false hrformation, including the possibility of fines and imprisonment for knowing
Violations30 -.901 v
(Signature of Permittee)
(Date)
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER -- Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG14O000
CERTIFICATE OF COV GE CIO. NCG14 D_L $
FACILITY NAME: I A, Q d t
PERSON COLLECTING SAM1P
CERTIFIED LABORATORY: Lab #� �/A '—
kl Lab_#
LIMIT VIOLATIONS? YES -❑ NO'Q
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: Mm".. Q1011
SAMPLE QUARTER: - QJul-Sept ­QOct-Dec , OJan-Marct
COUNTY: e�.rcei 14,d . CO
PHONE NO. ( !O 13 *j 0 dt7
ADD -TO USTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW OPNA ❑Trout
OPTIONAL INFO:
CKApril-June
❑OtherA46�_
Outfall No.
Date Sample
a
Collected
(mm/dd/yrj
Type of Wastewater
(VE, RM, MD) z
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
SGT-HEM6
(mg/L}
Discharge
Duration
minutes )
Total Flow
{gallons/day}'
6-93'4
303'5
53
(15)6
-
-
Ell S
jbiROG
1 if wastewater systems have not discharged in this quarter —report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above -
a Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
If an effluent limit•is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.,,
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-5.5 S.U. for discharges to saitwaters.
s TS5 limits are 20 mg/L for wastewater discharges to HQW waters,10 mg/L for -Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of fart IV, Section A, including the Tiered Response Action_
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 How as per 15A
NCACO213.0224, Permit -tees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW". "NO DISCHARGE-) WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW"i TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERTIACATION FOR ANY t ORMATIOV REPORTED:
"I certify, under penalty of law, that this d6mment 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 submnitting false information, including the possibility of fines and Imprisonment for knowing
violations."
ee
(Signature of
Permit Date: 7/1./2010-06/30/2015
6-3o--l�
(Date)
Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OFIE NO. MCGI , Q
FACILITY NAME:A%� QS
-PERSON COLLECTihIG S PLFS:
• .CERTIFIED LABORATORY:. �' Lab #
/,' _-,Lab #
LIMIT VIOLATIONS? YES' ❑ NO ❑ A/#. -'
Part A: Wastewater Monitorine Reatimements
SAMPLE COLLECTION YEAR: r
SAMPLE Q RTE - ul-Set Oct -Dec a Jan -March ❑April -June
COUNTY:
PHONE NO. D `r
ADD TO LISTSERVE? DYES ONO --EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO:
Outfafi No.
Date Sample
Collected
(mm/dd/yr)
Type of Wastewater
(VI:, RM, MD)'
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
iPH usingDischarge
method I664A
S T-HEM6
Duration
(minutes)
Total Flow
(gallons/dayf
��
• bEn1
['�
+7 1LL
CENT t
AL rl�ta
i
1 if wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here- Please make sure to mark the sample quarter above.
z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning M), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled,
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
pH limits are 6-9 S.U. for wastewater discharges to freshwaters; and 6.8-5.5 S.LI. for discharges to saltwaters.
5TSS limits are 20 mg/L for wastewater discharges to HQW waters,10 mg/L for Trout and PNNwaters, and 30 mg/L for all other water classifications.
Permit Date: ,7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

s Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action_
' Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 028.0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report an a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW". "NO DISCHARGE") WITHIN 30_DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality .
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SKN THIS CER110CATIOR FOR ANY INFORMATION REPORTED:
°l certify, under penalty of taw, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel property 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, m the best of my knowledge and belief, true, accurate, and
complete. I am aw re that there are significant penalties for submitting false information,.induding the possibility of fines and Imprisonment for knowing
via ns." .
(Signature of Permittee)
Permit Date: 7/1/2010-06/30/2 015
(Date)
Last Revised 07/13/11
Page 2 of 2