NCS000057_MONITORING INFO_20180802

---STORIVIWATER-DIVISfON-CODING-SHEET-- -"--
PERMIT NO.
DOC TYPE
❑FINAL PERMIT
MONITORING INFO
APPLICATION
❑ COMPLIANCE
❑ OTHER
DOC DATE
❑ 2z)i �A O 0 OZ
YYYYMMDD

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS000057 SAMPLES COLLECTED DURING CALENDAR YEAR: 2018� _
(This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
FACILITY NAME _VenatorChemica_ls,_LLC. RECTIVE®
PERSON COLLECTING SAMPLE(S) An ela BakerlJonna Stein
CERTIFIED LABORATORY(S) PACE Labs Lab #
Lab #
CEITFFU51 FILES
DWR SECTION
Part A: Specific Monitoring Requirements
COUNTY Cabarrus
PHONE NO. [phone]
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Outfall
No.
Date
Sample
Collected
50050
Total
Flow if a
Total
Rainfall
Cu
Zn
TSS
COD
pH
moldd/ r
MG
inches
M L
M
M L
M
STD
001
8/2/2018
0.79
0.0524
0.157
3.7
28.4
7.18
002
8/2/2018
0.79
0.0163
0.0372
7.6
ND
7.57
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? yes X no
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements A1'%4
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total
Rainfall
Oil & Grease
(if appl.)
Non -polar
O&G/TPH
(Method 1664
SGT-HEM), if
appl.
Total
Suspended
Solids
pH
New Motor
Oil Usage
moldd/ r
MG
inches
m l
m l
unit
al/mo
Form SWU-247, Iasi revised 21212012
Page I of 2

STORM EVENT CHARACTERISTICS:
Date g l S 7
Total Event Precipitation (inches): 0,
Event Duration (hours): (only if applicable — see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"1 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 violations."
of Permittee)
9' /& !/d
(Date)
Form SWU-247, last revised 21212012
Page 2 of 2

�F
Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit htt}Ls://deg.nc.govlabout/divisions/energy-mineral-land-
resources/energy-mineral-Ian d- en rmits/stormwater-permits/nodes-industrial-sw#ta -4
Permit No.: N/C/s ID lj/CJ/ d/s/ 7/ or Certificate of Coverage No.:
Facility Name: V6,4470fl CWMICALS� t LC.
County: Phone No.
Inspector: H! aW m lC _ / Jam �rw 14
Date of Inspection: O "off' off' o W
Time of inspection: `1 • as- Awl
Total Event Precipitation (inches): 0 , + `
..............-.-.-.-._.......... _.........-._.....-_ �..... .......................--�-�-�----.-.................-._-.-..-...-.-.-.-.-.-.�.-.--.-...-.-.�.�.......
All permits require qualitative monitoring
tobeperformed during
........
a "measurable storm event."
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 DEMLR Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
a�
(SignatuEVPermittee or Designee)
1. Outfall Description:
Outfall No. # C)o I _ , Structure (pipe, ditch, etc.):
Receiving Stream: KOCAV gbXK—
DescVibe the industrial acti ities that occur within the outfall drainage area:
Pagel of 2
SWU-242, Last modified 07/28/2017

1
2. Color: Describe the color of the discha
(light, medium, dark) as descriptors: L; _
using basic colors (red, brown, blue, etc.) and tint
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): A/bArE
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 V 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:
0 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:
0 2 3 4 5
7. Is there any foam in the stormwater discharge? OYes pNo.
8. Is there an oil sheen in the stormwater discharge? O Yes 0 No.
9. Is there evidence of erosion or deposition at the outfall? O Yes 0 No.
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.
SWU-242, Last modified 07/28/2017
Page 2 of 2

Environmental
Quality
Stormwater Discharge Outfall (SD4)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit https:/f deg.nc,govlabout/divisions Zen ergy-mineral-land-
resources/energy-mineral-land_ eerrm-lie-permits/nndes-indu5trial-sw#tab-4
Permit No.: N/C/S /0/a/ a/d /S/'�/ or Certificate of Coverage No.: N/C/G/_/_/_/_/_/_/
Facility Name: ye,111 —Iz C 1W- t: �Lr , L L., G
County: "Acr+N� _ Phone No. 14SIs- TH 1 rl 1
Inspector:
Date of Inspection:
Time of Inspection:
g'=a - �20i
Total Event Precipitation (inches): O"
79
A
All permits require qualitative monitoring to be performed during a "measurable storm event."
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 DEMLR Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signa
" j - � r- c-::: - �--
or Designee)
1. Outfall Description:
Outfall No.,,,-oda
Receiving Stream: K�s,
ditch, etc.): . PC -
Describe the industrial acthities that occur within the outfall drainage area:
Pagel of 2
SWU-242, Last modified 07/28/2017

4i
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C- 1,0AC _
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): 406tC
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:
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:
O 2 3 4 5
7. Is there any foam in the stormwater discharge? 0Yes ®No.
8. Is there an oil sheen in the stormwater discharge? O Yes •
9. Is there evidence of erosion or deposition at the outfall? O Yes ® No.
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.
SWU-242, Last modified 07/28/2017
Page 2 of 2

�i STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permif Number NCS000057 SAMPLES COLLECTED DURING CALENDAR YEAR: 2018
(This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
FACILITY NAME Chemical Specialties, LLC. COUNTY Cabarrus
PERSON COLLECTING SAMPLE(S) Angela Baker PHONE NO. (704) 4554177
CERTIFIED LABORATORY(S) PACE Labs Lab # 12 _ LCE JV s 1 r
Lab tf V
MAR Z 2 zo1 SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Part A: Specific Monitoring Requirements Ct_N7-�L i:I�
IDIAJF? SEr'rrn
Outfall
No.
Date
Sample
Collected
50050
Total
Flow (if app.)
Total
Rainfall
Cu
Zn
TSS
COD
pH
mo/ddl r
MG
inches
M L
M L
M L
M L
STD
001
3/12/2018
0.53
0.0634
0.120
58.5
51.0
8.59
002
3/12/2018
0.53
0.0441
0.104
78.5
30.0
7.44
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? yes X no
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total
Rainfall
Oil & Grease
(if appl.)
Non -polar
O&G/TPH
(Method 1664
SGT-HEM), if
appl.
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/dd/ r
MG
inches
m l
m /l
unit
al/mo
Form SWU-247, last revised 21212012
Page] of 2

:,
STORM EVENT CHARACTERISTICS:
Date3-IA- J? O, s
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"1 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 violations."
—SA41,e
(D;�e)
Form SWU-247, last revised 21212012
Page 2 of 2

A�
r�►�Mw..rrrr
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: enr.org/web/1 des- storm waterl
Permit No.: N/C/ S /0 / Q / 0/ 0 /5 / 7/ or Certificate of Coverage No.: N/C/G/_/..,._/—/_/_/_/
Facility Name: Chemical Specialties, LLC.
County: Cabarrus Phone No. 704-455-4177
Inspector: Angela Baker
Date of Inspection: 3/1212018
Time of Inspection: 10:06 am
Total Event Precipitation (inches):
Was this a "Representative Storm Event" or "Measureable Storm Event" 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:
ermittee-6r D
Page 1 of 2
5WU-242, Last modified 7/31/2013

1. Outfall Description:
Outfall No. 001 Structure (pipe, ditch, etc.) Ditch
Receiving Stream: Rocky River
Describe the industrial activities that occur within the outfall drainage area:
Chemical Manufacturing
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Light Brown Liquid
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): None
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 V 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:
V2 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:
6? 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
B. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes oNo
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
SWU-242, Last modified 7/31/2013

���
�
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: http;f /portal.ncdennorg1web/Ir/npdes-Stormwater/
Permit No.: N/C/ S /0 / 0 / 0/ 0 /5 / 7/ or Certificate of Coverage No.:
Facility Name: Chemical Specialties, LLC.
County: abarrus Phone No. 704-455-4177
Inspector: Angela Baker
Date of Inspection: 3112/2018
Time of Inspection: 9:58 am
Total Event Precipitation (inches):
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
XYes ❑ 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:
ofP
Pagel of 2
5WU-242, Last modified 7/31/2013

1. Outfall Description:
outfall No. 002 Structure (pipe, ditch, etc.) Pipe
Receiving Stream: Rocky River
Describe the industrial activities that occur within the outfall drainage area:
Chemical Manufacturing
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Light Brown Liquid
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): None
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 0 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:
2 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 Q
9. Is there evidence of erosion or deposition at the outfall? Yes
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
SWU-242, Last modified 7/31/2013

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS _ _0 �_�� SAMPLES COLLECTED DURING CALENDAR YEAR: c9O J I
ti (This monitoring report shall be received by the Division no later than 34 days from
REility receives the sampling results from the laboratory.)
FACILITYNAME C -a S 'A«'-'C-S «C, COUNTY r`*�
PERSON COLLECTING SAMPLE(S) ._A!nE-(A_ -9AKe2 _ ��� 2 Z��% PHONE NO. nc-voq) S:y-4191
CERTIFIED LABORATORY(S) PA(::;; Lab # la CENTRAL, FILES
Lab # DWR SECTION
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Part A: Specific Monitoring Requirements
Col
0
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes -[no
(if yes, complete Part B)
Form S WU-247, last revised 21212012
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date 9 `Iz-1 7 qq
Total Event Precipitation (inches): 0•
Event Duration (hours): (only if applicable — see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations."
re of
Form SWU-247, lost revised 21212012
Page 2 of 2

ICDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit. httn://portal.ncdenr.ora/web/lr/npdes::.stormwater/
Permit No.: 1`[/C/S/�
Facility Name: C
County: C
Inspector: ANEit
V /J /'%/ or Certificate of Coverage No.:
ct L Sn� ec,` c*eo ' G _G -
Phone No.
Date of Inspection: 4 - /,2 - o9 W 7
Time of Inspection: Jill AM _
Total Event Precipitation (inches): d,
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
0 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:
AJ J
(Signature of Per' or Designee)
Pagel of 2
SWU-242, Last modified 7/31/2013

1. Outfall Description:
Outfall No. O 0 ) Stru
Receiving Stream: nd�/
Describ the industrial activities
(pipe, ditch, etc.)
that occur within the outfall drainage area:
} rM
2. Color: Describe the color of the discharge isic
(light, medium, dark) as descriptors: ,r q
red, brown, blue, etc.) and tint
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): /b Af E5'
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 © 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
2 3 4 5
5. 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:
10 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
B. 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
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 7/31/2013

AFKWA
I .
FA
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: hip;//aortal.ncdenr.org/web/lrinpdes-stormwaterl
Permit No.: N/-C/ 5/ Q/ 4/ d/ O/5 / % / or Certificate of Coverage No.:
Facility Name: cg> p9 dAL-4IS [ GC.•
County: _�r_�kro_t..J' Phone No. %o - V/77____
Inspector: r.gt-LA -a'ACGiZ
Date of Inspection: 9-/11-01200
Time of Inspection: 9=oSAPA
Total Event Precipitation (inches): 0/
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
50 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:
of PentOCeee o —Designee)
Pagel of 2
SWU-242, Last modified 7/31/2013

1. Outfall Description:
Outfall No. CC) Structure (pipe, ditch, etc.)
Receiving Stream: C5=� t-�Uim
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the dischar e
(light, medium, dark) as descriptors: LA- hk+
basic colors (red, brown, blue, etc.) and tint
3. Odor: Describe any distinct odors that the discharge may have (i,e., smells strongly of oil,
weak chlorine odor, etc.): /JbA['E
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 © 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
a) 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:
lO 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes is
8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes
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
SWU-242, Last modified 7/31/2013

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year 2 al 7
Individual NPDES Permit No. NCSg� 4❑RM or
Certificate of Coverage (COC) No. NCG❑❑❑❑❑❑
This monitoring report
Facility Name: .
County:
Phone Number:
F
(,Lf
nmary of the calendar year should be kept on file on -site with the facility SPPP.
Total no. of SDOs monitored
Outfall No. /
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 {
�JqVo�y 2
Parameter, (units),
Total
Rainfall,
inches�1
Benchmark
N/A
Q, 00 72 .. 0,0 7
/ 00
/
Date Sample.
'Collected,
M
=
I
mmldd/yy
I y/ay/a0171 /, as 1 0• 0-�73 1 0, 0 993 I /0- 0 1 3V, 0 1 7. 1'Z0 I
19//a/,20/71 0, V V 1 0, 65Y 3 1 0, /ate 1 S• (a I N-D I (a I fr-3 I
SW U-264-Generic-13Dec2012

Additional Outfall Attachment
Outfall No.. A -
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No M
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No Ud
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 DWO to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No Ejj
SW U-264-Generic-13 Dec2012

I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations."
Signature
Date S z8
For questions, contact your local Regional Office:
DWQ Regional Office Contact Information:
SHEVII.LE REGIONAL O
AYE• L REGIO OFFIC►
OFFI
OORESVII,L WIPPEBIgo
225 Green Street
610 East Center Avenue/Suite 301
2090 US Highway 70
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
EIG REGION OFFIC`
ASHINGTON REGIONAL OFFIC•
M GTON REGIONAL O
943 Washington Square Mall
127 Cardinal Drive Extension
3800 Barrett Drive
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
1NSTON-SALEM REGIONAL OFFICPENjTVAIL
OFFIC
1617 Mail Service Center
Raleigh, NC 27699-1617
/- "To pmwm PMW
sndeManw
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
[phone]
1 AkuM CsraUna's waW.. "
SW U-264-Generic-13Dec2012

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year _ o[ 0/ 7
Individual NPDES Permit No. NCSLOUUI Oil-,11171 or
Certificate of Coverage (COC) No. NCG❑❑❑❑❑❑
This monitoring reportummary of the calendar year should be kept on file on -site with the facility SPPP.
Facility Nma�
County:
Phone Number: 0 ` f
(�) �S ,ST- �% % �' Total no. of SDOs monitored
pC
?'
�0-��
Outfall No.
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑
No
co
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?
y
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
f'U4 -.
r
wr.P-
-:i.. :.,� _ ,.r k 3M. :i,.
•� � Parainete unit`s .,
6 ad rr ,Sa 35
'.°'" 'iotal
Relnfall�, bb
.; _ - sry �" ,;«.v tw,' x : as.:v, �.
'_ f .f�•:r �S" .:.., �- ` �.: 4�1.�'S' Y•s'.y..,:�;�f, ."a�-✓y ,ti.:' - •a ' �u•- �v,.: tt,'.s����ryi}
,`••ter'.- �.p,`=' _,r.... _ �'"i Cam_T�f .p 'r`z �y . v
t s t z,.R sr r
:? i Asa
=`fix
-'?'� n vw5 ,�?:._^ a'x
LylL_
Benchmark
N/A
1 Q 00 73 0,0&7 00
Date. Sample
.
tollected
"; nmlddLyy
Qa Z
/, a2
2 73
0. 0 99
f 0- 0
3 V, U
7. a0
i aou
0• Vy
0, OY93
AI'
&, 93
SW U-264-Generic-13 Dec2012

Additional Outfall Attachment
Outfall No.. ,�wl
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 E.
�;e< �,�.,;��•�
.a�_
fi
�-
•
0�.<.
�,�
�- %�.f"�
Total'
'�.e"'iiecL� ,•
����:a�-� .
x' 4.-k.
.. ,.f....-
4vt/1
�.�;� _ �:�Parameter?{units �� ���y � ;,fix �:.��,3�-•�-��
ta. - .. � � 'aAE,ti- • ..�'•+�i`ti� •�; � � R `� � ':3 .r r r-,# :i 4*i a �:Y-•^,
Z.%� ;y.5;;
P-
,��: � ��` .r �L Fd � �� , � - � � : � � ,�:• ,,,,' �
_��
�Yz�l s�:
s
F: � �y � -
Benchmark
3 Da#ex$ample�-
Collected;
rriirti/d. ti
. N/A
017
D. o 6 -1
l 00
/
/. C/
a VV
010/67
/�0
7. y
SW U-264-Generic-13 Dec2012

IM
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations."
Signature
Date 5' :1
For questions, contact your local Regional Office:
DWO Re Iona! Office Contact Information:
IU A -
2090 US Highway 70
WAYMM-MaRM6 InFaM,
w
225 Green Street
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
(828) 2964500
Fayetteville, NC 28301-5043
[phone]
[phone]
943 Washington Square Mall
127 Cardinal Drive Extension
3800 Barrett Drive
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
1617 Mail Service Center-�,A.r4
Raleigh, NC 27699-1617
1 [phone]`
aiide+rfia oe 'l�;- *
'=
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
SW U-264-Generic-1 Mec2012

SifA
lm:^—
NCDEEIR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this farm, please visit: d - s tQrmw
Permit No.: N/C/ S/ O/ d / O/ D/X121 or Certificate of Coverage No.:
Facility Name:
County: OAJAA rek%Ls Phone No. O
Inspector: C
Date of Inspection: bll
RECEIVED
Time of Inspection: AyA
JUN 15 2017
Total Event Precipitation (inches): CENTRAL FILES
DWR $E,CTid� Was this a "Representative Storm Event" or "Measureable Storm Event" as de ine y the permit?
(See information below.)
AYes ❑ 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:
ture of Fe or Designee)
Pagel of 2
SWU-242, Last modified 7/31/2013

1. Outfall Description: I
Outfall No. QQ I Structure (pipe, ditch, etc.) -I-ac'%
Receiving Stream: K V ram' "re k
Describe the 'ndustrial activitie that ccur within the outfall drainage area:
2. Color: Describe the color of the disch rge us'ng basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: )a
�.
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): At4/P5-
4. Clarity: Choose the number which best describes the clarity of the discharge, where i is
clear and 5 is very cloudy:,
1 2 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:
0 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes V�o
9. Is there evidence of erosion or deposition at the outfall? Yes No
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
SWU-242, Last modified 7/31/2013

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT -
Permit Number NCS .006on
FACILITY NAME e C e-CI)q�_6LI
PERSON COLLECTING SAMPLES Am�wd TA�erc
CERTIFIED LABORATORY(S) C C-7 Lab
Lab #
Part A. Specific Monitoring Requirements
i
SAMPLES COLLECTED DURING CALENDAR YEAR: oZ/7
(This monitoring repoH shalt be received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
I -
COUNTY CAdr r.-S,
PHONE NO. 95-s-- 14177
SIGNATURE OF PERmTrrEE OR DESIGNEE
REOUIAElD ON PAGE 2.
N-"�
%
�DRFR2
M
0M
K
"Ki'
N
ON
V19'111017;
703
0, ItRl -3
Qzt9 73
'//0, 10
0
(3
a d
asw
­703
/1 ;2 ZX
j(/)
01 02V
rZ, -;)2.
"X>
7. _3
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? yes X ,.no
(if yes, complete Part B)
Part B: Vehicle Maintenance Ac ivity Monitoring Requirements AIIA
Z: Z
_0856�$
94 A
u A.
Now
�SF.ippLe
Z
6 147 -
'
;Total'`P
Ni 6WE
SC
Cill -r&l L
applicable)
RaEnfallm_Mprapp
G/T�P
idi!7
Suspended
-
OWUWgW�"!'-'
,(if
5
Actuou 16b4
Solids
-7--b-1
z,
MM!
M
1
Form S WU-247, last revised 21212012
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date '� /-//g
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable - see permit.)
1
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable -- see permit.)
Mail Original and one copy to:
(Division of Water Quality
IAttn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and 'imprisonment for knowing violations."
�7
(Signatu a of Permitte(Date
Form SWU-247, last revised 21212012
Paae 2 of 2

AYV4A
NCDE R. _
Stormwater Discharge Outfall (SDO)
Qualitative Monitofing° Report
Forguidance on frlling out this farm, please visit: httR;fZVoMal.ncdenr.org/web/irZnodes-stormw.atW
Permit No.: N/C/,
Facility Name:. S
County: S 'Ain
Inspector:
Date of Inspecti n
4/0/ JjOl/ T/7/ or Certificate of Coverage No.:
Time of inspection: K: a3 '�fvt
Total Event Precipitation (inches):. as
Was this a "Representative Storm Event" or °Measureable Storm Event" 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:
Page 1 of 2
SWU•242, last modified 7/31/2013

1. Outfall Description:
Outfall No.
Receiving Stream:
Describe theknoustrial agivi
2. Color: Describe the color of the
(light, medium, dark) as descriptors:
pe,
etc.)
witnin the outran aramage area:
rge using basic colors (red, brown, blue, etc.) and tint
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.):���
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
0 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:
10 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:
2 3 4 5
7. is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes oNo
9. Is there evidence of erosion or deposition at the outfall? Yes (No
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
SWU•242, Last modified 7/31/2013

/V:fSb6at-7
Chemical Specialties, Inc.
5910 Pharr Mill Road Harrisburg, NC 28075
EPA ID: NC 01229
CERTIFICATE OF ANALYSIS
Stormwater RECEIVED
JAN 4 zoll
Analysis of Samples for p3I
SM4SOOH+ I3 CENTRAL FILES
DWR SECTION
Date of Analysis; 12/06/16
Sample Q Test pH
1) Outfall 41 Test 1 7.16 at 12.2 °C
2) OutfalI it 'rest 1 7.59 at 10.0 °C
Analyst Signature:s.�
Mavis W. Jones

aceAnalytrcal
~.pecelabs.corn
December 16, 2016
Angela Baker
Chemical Specialties Inc.
5910 Pharr Mill Rd
Harrisburg, NC 28075
RE: Project: Stormwater
Pace Project No.: 92322075
Pace Analytical Services, LLC
9800 KlnceyAve. Suite 100
Huntersville, NC 26078
[phone]
Dear Angela Baker:
Enclosed are the analytical results for sample(s) received by the laboratory on December 06, 2016,
The results relate only to the samples included in this report. Results reported herein conform to the
most current, applicable TNIINELAC standards and the laboratory's Quality Assurance Manual,
where applicable, unless otherwise noted in the body of the report.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Taylor Ezell
[e-mail]
Project Manager
Enclosures
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except In full.
without the written consent of Pace Analytical Services, LLC,
Page 1 of 14

aceAnalyifical
wwwpacelabs.com
CERTIFICATIONS
Project: Stormwater
Pace Project No.: 92322075
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Charlotte Certification IDs
9800 Kincey Ave. Ste 100, Huntersville, NC 28078
South Carolina Certit1catlon #: 99006001
North Carolina Drinking Water Certification #: 37706
Florlde/NELAP Certification #: E87627
North Carolina Field Services Certification M 5342
Kentucky LIST Certification #: 84
North Carolina Wastewater Certification M 12
VirginlaIVELAP Certification #: 460221
Asheville Certification IDs
2225 Riverside Drive, Asheville, NC 28804 North Carolina Wastewater Certification #: 40
Florida/NELAP Certification #; E87648 South Carolina Certification M 99030001
Massachusetts Certification #; M-NC030 Virginia/VELAP Certification #; 460222
North Carolina Drinking Water Certification A 37712
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC. Page 2 of 14

aceAnalytical e
wwwpacelebs.com
SAMPLE ANALYTE COUNT
Project: Stormwater
Pace Project No.: 92322075
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huwersville, NC 28078
[phone]
Lab IA Sample ID Method
Analysts
Analytes
Reported
Laboratory
92322075001 Outfall#1 EPA200.7
SH1
2
PASI-A
SM 92220
KDF
1
PASI-C
SM 2540D
MLS
1
PASI-A
SM 5220D
MDW
1
PASI-A
92322075002 Outfall#2 EPA200.7
SH1
2
PASI-A
SM 9222D
KDF
1
PASI-C
SM 25400
MLS
1
PASI-A
SM 5220D
MDW
1
PASI-A
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC. Page 3 of 14

e
_ aceArralytilcal
wwwPacelabs'mr;
ANALYTICAL RESULTS
Project: Stormwater
Pace Project No.: 92322075
Pace Analytical Services, LLC
9B00 Kincey Ave. Suite 100
Huntersvihle, NC 28078
[phone]
Sample: Outfall #1
Lab ID: 92322075001 Collected: 12/06/16 09:56
Received: 12/06/16 14:50 Matrix: Water
Parameters
Results Units
Report Limit DF
Prepared
Analyzed CAS No, Quai
200.7 MET ICP
Analytical Method: EPA200.7
Preparation Method: EPA200,7
Copper
34.6 uglL
5.0 1
12/09/16 04:35
12/16/16 02:36 7440-50-8
Zinc
143 uglL
10.0 1
12J09/16 04:35
12/16116 02:36 7440-66-6
MBIO 9222D Fecal Coliform CHT
Analytical Method: SM 9222D
Fecal Coliforms
880 CFU1100 mL
1.0 1
12/06/16 15:29 ul
2540D Total Suspended Solids
Analytical Method: SM 2540D
Total Suspended Solids
6.4 mglL
2.5 1
12/12/16 11:08
5220D COD
Analytical Method: SM 52200
Chemical Oxygen Demand
ND mg1L
25.0 1
12/08/16 00:28
Data: 12116/2016 03:03 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC,
Page 4 of 14

1ceAnalyfical
www.walabs.cnm
ANALYTICAL RESULTS
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: Stormwater
Pace Project No.: 92322075
Sample: Outfall #2
Lab ID: 92322075002 Collected: 12/06/16 09:48
Received: 12/06116 14:50 Matrix: Water
Parameters
Results units
Report Limit
OF
Prepared
Analyzed CAS No. Qual
200.7 MET ICP
Analytical Method: EPA200.7
Preparation Method: EPA200.7
Copper
25.5 ug/L
5.0
1
12/09/16 04:35
12/16/16 02:49 7440-50.8
Zinc
102 ug1L
10.0
1
12/09116 04:35
12/16/16 02:49 7440-66.6
MBIO 9222D Fecal Coliform CHT
Analytical Method: SM 9222D
Fecal Coliforms
940 CFU/100 mL
1.0
1
12/06/16 15:29 u1
2540D Total Suspended Solids
Analytical Method: SM 2540D
Total Suspended Solids
22.2 mg/L
5.0
1
12/12/16 11:08 06
5220D COD
Analytical Method: SM 5220D
Chemical Oxygen Demand
NO mg/L
25.0
1
12/08/16 00:28
Date: 12/16/2016 03:03 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 5 of 14

aceAnalytical
ww+upacalabsx=
QUALITY CONTROL DATA
Project: Stormwater
Pace Project No.: 92322075
QC Batch: 339904 Analysis Method: EPA 200.7
QC Batch Method: EPA 200.7 Analysis Description: 200.7 MET
Associated Lab Samples: 92322075001, 92322075002
METHOD BLANK: 1885335 Matrix: Water
Associated Lab Samples: 92322075001, 92322075002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Copper ug/L NO 5.0 12/16/16 02:12
Zinc uglL NO 10.0 12/16/16 02:12
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
LABORATORY CONTROL SAMPLE: 1885336
Spike LCS LCS % Rae
Parameter Units Cone. Result % Roe Limits Qualifiers
Copper uglL 500 509 102 85-115
Zinc ug/L 500 490 98 85-115
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 1885337
1885338
MS
MSD
92322445002 Spike
Spike
MS
MSD MS
MSD % Roe
Parameter Units Result Cone.
Cone.
Result
Result % Rae
% Roe Limits RPD Qual
Copper uglL 15.4 500
500
510
518 99
100 70-130 2
Zinc uglL 56.4 500
500
525
539 94
96 70-130 3
MATRIX SPIKE & MATRIX SPIKE DUPLICATE:
1885339
1885340
MS
MSD
92322336001
Spike
Spike
MS
MSD
MS MSD
% Rae
Parameter Units
Result
Cone.
Conc.
Result
Result
% Roe % Rae
Limits RPD Qual
Copper ug1L
NO
500
500
518
661
101 108
70-130 6
Zinc ug1
NO
500
500
536
574
106 114
70-130 7
Results presented on this pug* are In the units Indicated by the "Units" column except where an alternate unit In preeeMed to the right at the rsauit.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except In full,
Date: 12/16/2016 03:03 PM without the written consent of Pace Analytical Services, LLC.
Page 6 of 14

aceAnalyiical
w*wpacafabs.com
QUALITY CONTROL DATA
Project: Stormwater
Pace Project No.: 92322075
QC Batch: 339785 Analysis Method: SM 9222D
QC Batch Method: SM 9222D Analysis Description: 92220 MBIO Fecal Coliform - CHT
Associated Lab Samples: 92322075001, 92322075002
METHOD BLANK: 1884393 Matrix: Water
Associated Lab Samples: 92322075001, 92322075002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Fecal Coliforms CFU1100 mL ND 1.0 12/06/16 15:29
SAMPLE DUPLICATE: 1884394
Parameter
Fecal Coliforms
92322097001 Dup
Units Result Result RPD Qualifiers
CFU1100 mL 5300 600 159 u2
Pace Analytical Servlcos, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 2BO78
[phone]
Results presented on this paps are in the units Indicated by the "Units" column except wham an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 12/16/2016 03:03 PM without the written consent of Pace Analytical Services, LLG.
Page 7 pf 14

to
ace Analytical
wwwpacefaba.com
Project: Stormwater
Pace Project No.: 92322075
QC Batch: 340332
QC Batch Method: SM 2540D
Associated Lab Samples: 92322075001, 92322075002
METHOD BLANK: 1887729
Associated Lab Samples: 92322075001, 92322075002
Parameter Units
Total Suspended Solids mg1L
QUALITY CONTROL DATA
Analysis Method: SM 2540D
Analysis Description: 2540D Total Suspended Solids
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 2.5 12/12/16 11:00
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Hunlersville, NC 28078
[phone]
LABORATORY CONTROL SAMPLE: 1887730
Spike LCS LCS % Roe
Parameter Units Cone, Result % Roe Limits Qualifiers
Total Suspended Solids mg/L 250 248 99 90-110
SAMPLE DUPLICATE: 1887731
Parameter Units
Total Suspended Solids mglL
SAMPLE DUPLICATE: 1887732
Parameter Units
Total Suspended Solids mg/L
92322027001 Dup
Result Result RPD Qualifiers
ND ND
92322075002 Dup
Result Result RPD Qualifiers
22.2 14.2 44 D6
Results presented on this paps are In the units Indicated by the "Units" column except when on alternate unit Is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except In full,
Date: 12116l2016 03:03 PM without the wrltlen consent of Pace Analytical Services, LLC,
Page 8 of 14

aeeAnalytical
• �vww.pecelabs.corn
Project: Stormwater
Pace Project No.: 92322075
QC Batch: 339822
QC Batch Method: SM 5220D
Associated Lab Samples: 92322075001, 92322075002
METHOD BLANK: 1884712
Associated Lab Samples: 92322075001, 92322075002
Parameter Units
Chemical Oxygen Demand mg1L
QUALITY CONTROL DATA
Analysis Method: SM 5220D
Analysis Description: 5220D COD
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
NO 25.0 12/08/16 00:28
PaceAnalytieal Services, LLC
9B00 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
LABORATORY CONTROL SAMPLE: 1884713
Spike LCS LCS % Rae
Parameter Units Conc. Result % Rec Limits Qualifiers
Chemical Oxygen Demand mg/L 750 777 104 90-110
MATRIX SPIKE 8 MATRIX SPIKE DUPLICATE: 1884714 1884715
MS MSD
92322011002 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc, Result Result % Rae % Rae Limits RPD Qual
Chemical Oxygen Demand mg1L 195 750 750 925 923 97 97 90-110 0
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 1884716 1884717
MS MSD
92322129001 Spike Spike MS MSD MS MSD % Rae
Parameter Units Result Conc. Conc. Result Result % Rae % Roe Limits RPD Qual
Chemical Oxygen Demand mg1L 141 750 750 898 893 101 100 90.110 1
Results presented on this page are in the units Indicated by the "Units" column except whore an alternate unit Is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 12/1612016 03:03 PM without the written consent of Pace Analytical Services, LLC.
Page 9 of 14

Pace Analytical Services, LLC
e 9$00 Kincey Ave. Suite 100
ace Analytical Huntersville, NC 28078
www.pacefabs.corn
[phone]
QUALIFIERS
Project: Stormwater
Pace Project No.: 92322075
DEFINITIONS
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
NO - Not Detected at or above adjusted reporting limit.
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit,
MOL -Adjusted Method Detection Limit.
PQL - Practical Quantitation Urnit.
RL - Reporting Limit.
S - Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is
a combined concentration.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
M5(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Gel - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether.
A separate vial preserved to a pH of 4-5 Is recommended In SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrlle by EPA
Method 8260,
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyto is a combined concentration.
Pace Analytical is TN accredited. Contact your Pace PM for the current list of accredited analytes.
TNI - The NELAC Institute.
LABORATORIES
PAST -A Pace Analytica! Services -Asheville
PASI-C Pace Analytical Services - Charlotte
ANALYTE QUALIFIERS
D6 The precision between the sample and sample duplicate exceeded laboratory control limits.
u1 Results based upon colony counts outside acceptable range.
u2 Colonies are too numerous to count. Actual result may be greater than reported.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 12/1612016 03:03 PM without the written consent of Pace Analytical Services, LLC. Page 10 of 14

aceAnalyticale
wwwpwWabs.com
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: Stormwater
Pace Project No.; 92322075
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersvllle, NC 28078
[phone]
Lab ID
Sample ID
QC Batch Method
QC Batch Analytical Method
Analytical
Batch
92322075001
Outfall #1
EPA 200.7
339904 EPA 200.7
340235
92322075002
Outfall #2
EPA 200.7
339904 EPA 200.7
340235
92322075001
Outfall #1
SM 9222D
339785
92322075002
Outfall #2
SM 9222D
339785
92322075001
Outfall #1
SM 2540D
340332
92322076002
Outfall #2
SM 2540D
340332
92322075001
Outfall #1
SM 5220D
339822
92322075002
Outfall #2
SM 5220D
339822
Date: 12/1612016 03:03 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 11 of 14

Document Name:
Document Revised: Sept, 21, 2016
Sample Conditlon Upon Recei t SCUR
Page i of 2
Document No.:
Issuing Authority:
_.�2,eAnaVical"
F-CAR-CS-033-Rev.01
Pace Quality Office
Laboratory receiving samples;
Asheville ❑ Eden❑ Greenwood ❑ Huntersville © Raleigh[] Mechanicsville[]
Client Name;
project # W0� � 92322.0?5
cn), 1 C
L�ai'� t
'Courier:
❑Fed Ex ❑UPSOUSPS
_
❑Client
I
�
�I1
�1
❑ Commercial
©Pace
❑Other:
11 1 II
9232 075
Custody Seal Present?
[Dyes No Seats
Intact? ❑Yes
�No
�r Date/Initials Person Examining Contents;
Packing Material:
Thermometer:
❑Bubble Wrap ❑Bubble
Bags []None
[]Other:
❑ A Gun ll)
Type of Ito: Wet
❑Blue
❑None 12samples on Ice, cooling pr cess has begun
Correction Factor:
Cooler Temp Corrected ('C):
2 ,
Blologicai Tissue Frozen? []YesYo ❑ NJ' A:
Temp should be above fr
zing to 6'C
USDA'Regu ated Soil (
N/A, water sample)
Did'sampf oricinate in a quarantine
tone within the United
States: CA, NY, or SC (check
maps)?
Old samples originate from a forelan source (inter dtionally,
Yes No
Including Hawaii and Puerto Rico)? []Yes�No
Comments/otscrepa n cw
Chain of Custody Present?
Wes
EINO
N A
I.
:SamPies Ar+ived v;ithin Hold Time?
yes
OtA
QN/A
2.
Short Hold Time Analysis 42 hr.)?
0yes
MV.
N A
3.
Rush Turn Around Time Requested?
Qy4s
No,
N/A
a,
Sufficient Volume?
Eyes
CNo
N/A
S.
Correct Containers Used?
-Pace Containers Used?
9dV s
[]No
[]No
❑N/A
N/A
6.
Containers intact?
es
N/A
7.
Samples Field Filtered?
Ejyg
o
N A
S. Note If sediment is visible in the dissolved container
Sample Labels Match COC7
-liitludes oate/Time/ID/Analysis Matrix:—IlLi.
Yes
❑No
❑N/A
9.
Heads ace in VOA Vsals(>5.6mm)?
myes
Q
IA
10.
Trip Blank Present?
Tri Blank Custody Seals Present?
oyes
[:)yes
No
_[]NO
❑ /A
N/A
11.
CLIENT NOTIFICATION/RESOLUTION
Field Data Required? ❑Yes []No
Person Contacted: Date/Time:
Comments/Sample
Discrepancy;
i
i
l Z�Project Manager SCURF Review; T � Date; ,
�) jZ
Project Manager SRF Review: y Date:
Note: Whenever there is a discrepancy affecting North Carolina compliance samples, a copy of this form will be sent to the North Carolina DEH NR Certification Office (i.e.
Out of hold, incorreci preservative, out of temp, incorrect containers)
Page 12 of 14

0
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SP2U-500 mL Plastic UnpreServed (N/AI
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BP3N-250 mL plastic HNO3 (pH < 2)
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13133Z-250 mL Plastic ZN Acetate & NaOH (>9)
BP3C-250 mL Plastic NaOH (pH > 12) (CI-)
WGR)-Wide-mouthed Glass jar UnpreServed
AG1U-1 liter Amber UnpreServed (N/A) (CI-)
AG1H-1 liter Amber HCI (pH < 2)
AGAU-2S0 mL Amber Unpresenned (NIA) (M)
AG1S-1 liter Amber H2SO4 (pH <2)
AWS-250 mL Amber H2SO4 (pH < 2)
zzzzzAGM(DGMA
250 mL Amber NH4Cl (N/A)(CI-)
DG9H-40 mL VOA HCI (N/A)
VG9T-40 mL VOA Na25203 (N/A)
V69U-40 mi VOA LJnp (NIA)
DG90-40 mL VOA H3PO4 (N/A)
VOAK (6 vials per kit)-5035 kit (N/A)
V/GK (3 vials per kit}VPH/Gas kit (N/A)
SPST-12S mL Sterile Plastic (N/A — lab)
SPIT-250 mi Sterile Plastic (N/A — lab)
8P3A-250 mL Plastic (NH2)2SO4 (9.3-9.7)
Cubitainer
VSGGU-20ml-Scintillationvials (NIA)
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CHAIN -OF -CUSTODY ! Analyitcat Reauest Document
3_ Ar ird The Chia, of Ctestody i5;a iEGRI.f]C]CUMEM A11 reievant fields must be competed accurately.
Section A Sertian G Sec;%an C
P.equired Client IntO—tion: Required Project tn:or lioe] Invoice tntorrnntion: Page: (7f f
C=party. G.em::al l� Report Ta- Anpe,ta Sake:r Arerdton
Ackh ess: 597Q PhAtr ti.ti R0. Copy To, ,Comp rry Name:
f'iFxrisbug,NC2EQ75
-
AdtlreSS:
EtnaiE 0-ft, :.[`:.-. 5 Ewa C i.,#. % S1p e-,. s W
PerChase Order #;
Pace Owte, - -.
J:ft� tf-Si
Phone. ? f .j : f (f / Fa.
a
Projeu N=*. Seen%-Arexi l Slmnwater Zc ii, }
Pare PropM Manage, s�yl0f.tzet s cum-
- "` :State 1 Lecxlnn -
Rem&Wdd Date
Proje=
Pace ProtAft X: .1542-4
NC
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ADOrTKAWL COMMENTS
HY IAFHLEATM
DATE
TIME
ACCEPTED erY r AFFlLIATmb
"Te
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SAMPLER NAME AND SIGNATURE
C:
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SIGNATURE of SAMPLTE
DATE
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STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS 4 0 0 0 S 7
FACILITY NAME ckm w -nes L L 4
PERSON COLLECTING SAMPLE() r 44 t?Z eg 73r�:�xg
CERTIFIED LABORATORY(S) _.f?M C Lab
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: '21w (o
(This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
COUNTY CALA r ry 5 _
PHONE NO. ?b S - S//7r%
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
F
1
I
1
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yes &no
(if yes, complete Part B)
Part B: Vehicle Maintenance Activitv Monitorne Requirements AVA
CENTRAL, FILES
DWR SECTION
"fall -r
No_ .W
Date- ; `.
Sample -
50050 _ -
:. = _ :. _
00556- 7 �_.--
..
00530
00400
Total,Flow
Total _
Oil &Grease='"
-
Non polar
Total
pH
New Motor .
-
`Collected- =
if applicable)
Rainfall -
da�- l:
O&G/TPH`:
Sus ended
Oi1.Usa a
(Method 1664.
SolidsSGT.:..
-
..
_
•
a '1.
mo/ddlvr
MG - :
_1
=inches' ::
Fn/ l .:- _
mE/l ..-'
unit, -
ildlmo
Form S WU-247, last revised 21212012
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date/;I-6-J0 f0
Total Event Precipitation (inches): 676
6
Event Duration (hours): ' (only if applicable —see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
r s! �i. � C �► _i T. .
"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 violations."
llslel
(Signature of P tee) ate
Form SWU-247. last revised 2/2/2012
Page 2 of 2
F- • 0.

KNEW
RECEIVED
Stormwater Discharge Outfall (SDO) JAN 0.3 2017
Qualitative Monitoring Report CENTRAL FILES
DWR SECTION
Forguidance on filling out thisform, please visit: /lnortal.ncdenr.org/web/lanndes-stormWater/
Permit No.: a/-C/ S _/ 0/�/`/��/ or Certificate of Coverage No.:
Facility Name: fi CG G.
County: r,-u, S Phone No. 70Y- `%SS~ 5�/ 7,7
Inspector: kc2 —F� &LKAFI
Date of Inspection: /a
Time of Inspection: 24 A4
Total Event Precipitation (inches): Q /; U
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
CM 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:
Pagel of 2
sWU-242, Last modified 7/31/2013

V
1. OutfalI Description: Outfall No. 0 o 1 Structure (pipe, ditch, etc.) i-(-CL
Receiving Stream: J( 1, v
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
[light, medium, dark) as descriptors: 3C�Nzj I LJ9 w1
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): A10 n1-6
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 2 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
0 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:
0 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes
9. . Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: how clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
maybe indicative of pollutant exposure.. These conditions warrant further investigation.
F,
Page 2 of 2
SA-242, Last modified 7/31t2013

A74a
'�
RC- DG�
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
F'orguidance on filling out thisform, please visit: httpallnortal.ncdenr.org/weblrJnpdes-EQrmwater/
Permit No.: NVICA6
Facility Name: (1
County:.-A-�
Inspector•
Date of Inspectio
Time of Inspection:
or Certificate of Coverage No.:
Total Event Precipitation (inches)11
:, _
7
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
06 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:
Pagel of 2
SWU-242, Last modified 7/31/2013

1. Outfall Description:
Outfall No.
Receiving Stream:ps
Describe the industrial activi
(pipe, ditch, etc.)
-& rv—�Q
occur within the outfall drainage area:
2. Color: Describe the color of the discharge ubasic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C.IQar- Z singk+ -Rr-4%A'Al Ul wA
3. . Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): ,,L'a At C-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 0 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:
0 2 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
9. Is there evidence of erosion or deposition at,the outfall? Yes
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
maybe indicative of pollutant exposure.. These conditions warrant further investigation.
i
Page 2 of 2
SWU-242, Last modified 7/31/2013

114�rrali Number NCS 000057
STORAIWATER DISCHARGE OUT (SDO)
MONITORING REPOR
Sr.MPLES CO , U pe
AR YEr\R:(This monitoring report shal e(�Db the Division no later than 30 days from
the date the facility receives the sa �pling results from the laboratory.)
FACILITY NAME tkMl CAL Sf�1ALTTE5 , « C , GC �1/�D COUN—Ty, l�]A2 US
PERSON COLLECTING SAMPLE(S) A AKPHONE NO. _) Ste- Y 177
CERTIFIED LABORATORY(S) F Lab # �� li 6
Lab # EZ
CENTRAL FIDES ATURE OF PERMITTEE OR DESIGNEE
CW:T SECTION UIRED ON PAGE 2.
Part A: Specific Monitoring Requirements
Outfall- - _ _ = Date =: 50050
No . Sample Total _ _m Total- - _
-TS5
__.-._.._ Collected _ : -_: Flow_ if'a Rainfall . :. > C z n -
mo/ddlyr MG _ inches _. _ :phq _ .- ...•wco /L r+1a G- = =,. L,.., ST
11
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ` yes Xno
(if yes, complete Part B)
. 1/
Part B: Vehicle Maintenance Activity Monitoring Requirements fVIn
Outfall ..._ r_.1.6
ate, 50050: -: 00556 -00530: m 00400 __-:...:.. .: :. .: -
No Sample :Total Flaw Total= Oil'&FGrease Non=polar Total,` ` __ _ ... PH ; New.Motor -
-
collected r . tf a - Lcable ' :: Rainfall d a I
{� PP ) {. Pp ).- O&G/TPH Suspended _ Oil -Usage
` `(1Vietbod-lb64 Solids
- `SG
- T=HEM), if,:<-
_ - -
:._:.mo/ddh,inches _� - inPfl W ^ z ;mom -::unit
Form SWU-247, last revised 21212012
Page I of 2

S401VO EVENT CHARACTERISTICS:
Date Y`�7-&Xol�O 0. VA —
Event
Total Event Precipitation (inches):
Duration (hours): (only if applicable — see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
flail Original and one coPy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
includingthe possibility of fines and imprisonment for knowing violations."
( Z,4 r- �� 3 1 /,?-016
(Signature of Permitt ) (Date)
Form SWU-247, last revised 21212012
Page 2 of 2

y • 1
ALIT X-?FA
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: http://portal.ncdenr.org/webllrinpZ&s-stormwater/
Permit No.: NI-Cl-s/Q/ D/ Q/Q/ or Certificate of Coverage No.:
Facility Name: CIk A-(_ L C C _
County: CAIIA>2RV�J Phone No. 70V- L/S-S 9 1_"
Inspector: Ke1Z-
Date of Inspection:` /7- d` O_�_(4
Time of Inspection: Ud pjj6
Total Event Precipitation (inches): D� / ot
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
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 in.ches 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 thjs,-s;gnature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of PermittEe or Designee)
Pagel of 2
SWU-242, Last modified 7/31/2013

1. Outfall Description:
Outfall No. 00 t '
Receiving Stream:.
(pipe, ditch, etc.) J' -r�
Describe the industrial activities that occur within the outfall drainage area:
i .Mtrw cA C. � of uFf� CTcnRt � �
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: G�G-V &f314-,J bQLk(b
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): AMr4
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 V 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:
J 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:
2 3 4 5
7. Is there any foam in the stormwater discharge? Yes Na
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfali? Yes No'
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
5WU-242, Last modified 7/31/2013

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: htt •llportal.ncdenr,grg/web/lr/nudes-stormwater/
Permit No.: N,
1 acility Name:
County: GA
Inspector: 1Ct.1L
Date of Inspection:
Time of Inspection: �a� ✓`��p�'►'\ _ _
Total Event Precipitation (inches): 0• o—
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
xYes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
q Qualitative monitoring requirements vary. Most permits require qualitative monit
oring 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
j obtains approval from the local DWQ Regional Office.
By this sjgnature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permitteror Designee)
Page 2 of 2
SM-242, Last modified 7/31/2013

1.. Dutfall Description: y
0utfaII No. CXSA�Z tructure (pipe, ditch, etc.)
Receiving Stream: r—&y 1ZIy 61K
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the di charge 2('14F—
g basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: �: -%Arj f.l Opt
3. Odor: Describe any distinct o
weak chlorine odor, etc.): /Ai`
that the discharge may have (i.e., smells strongly of oil,
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 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:
V 2 3 4 5
G. 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:
D 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes ED
8. Is there an oil sheen in the stormwater discharge? Yeses
9. Is there evidence of erosion or deposition at the outfall? Yes 11�0
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
SWU-242, Last modified 7/31/2013

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS 0 0 0 0 -5-7
FACILITY NAMEr
PERSON COLLF(C�TM
'G SAMPLE(S)P-64 6LA5&aZ-r--
CERTIFIED LABORATORY(S) PA C Lab #.
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 5
(This monitoring report shall be received by the Division no Inter than 30 days QoW
the date the facility receives the sampling results from the laboratory.}C..".)
COUNTY CA AA QZ U-S '
PHONE NO. CZ&Y)_ &77 Lai
SIGNATURE OF PERmrrrEE ORDESIGNEE
REOUFRED ON PAGE 2.
5
esm ;m-
-mr
-M-
WR0FE
r
,onTtaIR
A MUK
L.
-7
001
Vimo a Taws-
-7�7,�
1-10
�d
04-0 91 V
C)0,;;L
ICV2712W
(1, 6? 5-
1 - /0
0- 0 Y-3-7
61, 87V
27, a
5-- 0
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes
(if yes, complete Part B)
Part B- Vehicle Maintenance Activity Monitoring Requirements A//A
.04400-
!N5`%:aF 'o
. I
" j Flow"
-a -� T-
Zf
Oil' re s
-W'- -.
i.
WAVM torii
k
.
aufi
-R�
w!-tap� e
-K
M
a pl.,
-irSus
a aed-
....
-WWIN
rS—HEN)-'HENNf9
..
FMWROM
FOM'
MM; W,
-fi a y i 60- vwl M.
'Form SWU-247, last revised 21212012
Page 1 of 2

r- . 4
STORM EVENT CHARACTERISTICS:
Date /0-R7-o21�1S .
Total EventTrecipitadon (inches): _
Event Duration (hours): (only if applicable - see permit.)
. ' (if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable - see permit.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-.1617
"I certify; under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the.possibility of fines and imprisonment for knowing violations."
(Signature of Permittee) . (Date)
Form SWU-247, last revised 21212012
Page 2 of 2

A OW
ND�
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: hUp:ljportal.ncdenr.org/webllanpdes-storinwat
fweb/lanndes-stormwaterl
Permit No.: N/C/,'
Facility Name:. C
County: CA 4-rj
Inspector: ENM
Date of Inspection:
Time of Inspection: I a ' pm
Total Event Precipitation (inches):
or Certificate of Coverage No.: N1/C/fil_1.`1-1-..J^/_/
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
0 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 Permittee or Designee)
Pagel of 2
•5WU-242, Last modified 7/31/2013

I. ' OutfallDescription:
Outfall No.
Receiving Stream: Ri
ditch, etc.)
occur within the outfall drainage area:
2. Color: Describe the color of the Oischarge using basic colors
(light, medium, dark) as descriptors: irrhrf— Mfjk&�
brown, blue, etc.) and tint
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): NOAuC
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 3 4 5
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:
6 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes 601/
8. is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes No
10.. Other Obvious Indicators of Stormwater Pollution:
List an describe 1 4t/
aP C/ ;W .� -1 V.(ff' m
At)_-sA e,,A-r i�t1a1c -R4 rG �FrLFni F
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 7/31/2013

wr►�
NCDE�VR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on f lling out this farm, please visit: httn:/lnortal.ncdenr.org f web jlr/nodes-stormwzterl
Permit No.: jY/�//�_/_/Q/�_/ or Certificate of Coverage No.: h[/Qfi/
Facility Name: sCAL S ECck LT7 C .
County: 0, A M6L S Phone No. oc!,V S T- 7
Inspector: aty dA_ RAICK 0-
Date of Inspection: l b- 29 - 3-CS l 5
Time of Inspection: V 05 r2
Total Event Precipitation (inches): ( , 10
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
Dd 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.
13y this signaWte, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
ti Pagel of 2
1
SWU-242, Last modified 7/31/2013

1. Outfall Description:
Outfall No. 2
Receiving Stream:
Describe the industrial activi-
(pipe,_ditch, etc.)
that occur within the outfall drainage area:
I7-LA Q i /V - G-
2. Color: Describe the color of the ischarge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: , Cr r E4 LJ V 61 Q W D
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): A)QWr
4. Clarity: Choose the number which best describes the clarity. of the discharge, where 1 is
clear and 5 is very cloudy:
1 C2D 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:.
61 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:
2 3 4 5
7. Is there any foam in the stormwater discharge? Yes Q
8. 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:
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
1'
SWU-242, Last modified 7/31/2013

i
3
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS OU Q-0 5-7 SAMPLES COLLECTED DURING CALENDAR YEAR: DIS
(This monitoring report shall be received by the Division no later than. 30 days from
the date the facility receives the sampling results from the laboratory.)
FACILITY NAME r, "r*%Z r-t� �`�� C COUNTY eAL4rrAS
PERSON COLLECTING SAMPLE(S) CLA t L //+ EC E i 1% E ® PHONE NO. USY) - /
CERTIFIED LABORATORY(S) _ Lab # _ 1�2
Lab # MAY o S 2015
Part A: Specific Monitoring Requirements
SIGNATURE OF PERMITTEE OR DESIGNEE
CENTRAL F1LE REQUIR
DVVR NL ED ON PAGE 2.
a.1.:_. '_ "_
. a-._
-Collected �'•....
_.,�. "..'-=':
Total
r�.w'--w,3a.;.'.>,-
Flo_wx �f:a
--^£--DTP'^.7e
Total
Y "t'x.4
acNi
:Raldfall_..-'---.tra?1.:-_.
�_ e:�: -CM:. F--
�.1 -
i
- -:L -
x."�-
l.
..:i.:.: ..Rw'
_ P',
. '.,..�..
..--'.A�F. _Y.--
%� i- S Y7.
4
`« x
s Y' x °
��
-i"a 3,.:
, - S a57y
�_ a fc
_x.» --
/..
;mo/�d1 r�
�G_ ::��nchie$
;
"k..'Y�.Ge
_ :i3 S .ab4yt:.Ce
�u"d
1
01
G Z015-
0, ;23
n, y 0
a
an
0 i
;2 o
C�!
(i 401�7
!
7'`
-5
1
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes i.4o
(if yes, complete Part B)
Part B: Vehicle Maintenance Activitv Monitoring Reauirements A
Outfall�
50050,E
..._..... .: -ff��. -_-
-00556 a77
T4
00530
i600Q OW
a3
:
-Date �
Sample
Total Flow
Total
Oil°8c Grease 'Non
-polar '
Total t
pH*'
_.,
New Motor 2
.No
' `
Collected
" if a licable
� PP )
=Rainfall -
( tf:a i .�
O&G /I'PH
Sus ended
P
OBI Usa e
g
� ; �
f � �. .�
DPP)
� -
-r
' d - yh•r
a
'L.-_.-11__'S�"'4:.i.
M•
'-z
-
a€E"�: 4'y'�`'.' kF
3 { ki -.@
a^ .....-, e
7
:,," 8..
t ,
x -r: _ - -� €
-
_..�3^^r�'.• -'2,
.' i" 1. .4"
:.. ": .;�TLt`�ti
•
f'S =Gd i'�7!''i
R
r�. "C:e.
,� _�.=3S "
i .:;."C•- ^..,.I~. a
-K e: .i- ai.
$:_ 3: , -_ "�•:.. -
#nu ....-'�" '.:._Y' a._£.,..
�`�," -'i' .....: �a
�' :l_ ---•-- i
_. 1 '. ,`i.'...1"- ,.
.$.. I
74
-.if
m
umt._y
aUtno
_
.m .� , r
,. ,Y
i
Form SWU-247, last revised 21212012
Page 1 of 2
aaaaaaa=.wa

j
{i
STORM EVENT CHARACTERISTICS: iMail Original and one copy to:
Division of Water Quality
Date V / Attn: Central Files
Total Event Precipitation (inches):. 11617 Mail Service Center
Event Duration (hours): (only if applicable -- see permit.) Raleigh, North Carolina 27699-1617
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
"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 inquiU of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations."
. i
(Signature of Permittee (Date)
i r
i
Form SWU-247, last revised 21212012
Page 2 of 2

IM
Stormwater Discharge Oudall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: http: f /n"]„ncdenr.orL/webIlyq/ws/su jn do etiiAtab-4
Permit No.: S 0 O 4 p 5`
L�[/�/ /_/�/._/ Z/ or Certificate of Coverage lYo::�j`[/.�/i�/_/^/_/_/_/..._/
FacilityName: - tvif Oq C a - C UfC77i-:S L (L
County: CA?,A 22utS _ _ _ Phone No. oY4 L V177
Inspector: El.fl `C C .lC / 1J�� 4ACr�`
.Date of Inspection: 72csi S-
Time of Inspection: _ 3 ' 3 5 R*.VO
Total Event Precipitation (inches): L!,
Was this a 7Fesentatfve Storm Event" or "Measureable Storm Event" as defined by the permit? .
(See information below.) ;
No
Please verify whether Qualitative Ionitoring must be performed during o "representative storm
event"or `hieasureable foam e�rent"(requlrements.v`ai'y, depending on the;permit).
Qualitative monitoring requirements vary.. -Most permits require qualft. tdve monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits donot 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
j 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
precipftatfon.
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
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 Permfttee or Designee)
Page 1 of 2
SWU-242, Last modified 10/25/2012

i
I. Outfall Description:
Outfall Na. r Structure (pi ,.ditch etc.) ' Receiving Stream: L1
Describe the industrial activities th t oc .ur within the outfall drainage area:
OA MI CAL ,6 UPA� CTU2//V C—
2. Color: Describe the'color of the di charge usin asic colors (red, brown,•blue, etc.) and tint
(light, medium, dark) as descriptors: l �T 1xMIJ A/ L I Gk
3.- Odor: Describe any distinct odor that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, itc.): / PM] _
4. Clarity: Choose the'number.which best describes the clarfty of the discharge, where 1 is
clear and 5 is very cloudy:
1 C 3 4 5
i
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
5:' 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-'
2 3 4 5
'-7: Is there any foam in'the stormwater discharge? Yes, nNo
'8. ' Is thereman oil sheen in the stormwater discharge? Yes V
9. Is there evidence of erosion or deposition at the outfall? es No
10. , Other Obvious Indicators of Stormwater Pollution:
List'arid 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
SWU-242, Last modffled 10/25/2012 `

AS�
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on f lling out this form, please visit: hCtp-./IpQrtal.ncdenr.org/syeb/wq/ml/,u jnpdessw#tab-A
Permit No.: h[/.C/S/ /O/D/ or Certificate of Coverage No.: HILIfL/_/_/,-,T,/_/._/_/
Facility Name: L -S' GL C.
County: Phone No. oy - v17%
Inspector: &CIA I KEJf- C
Date of inspection: -
Time of inspection:
Total Event Precipitation (inches): D' J
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
0 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
j 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 thi gnat e,1 certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
Page 1 of 2
5WU-242, last modified 10/25/2012

1. Outfall Description:
Outfall No.Structure
Receiving Stream: .'Q
ditch, etc.)
Describe the industrial activi s that occur within the outfall drainage area:
(' (A L /�1,w�-ic.-rcgrt1'VC"
2. Color: Describe the color of the discharge using basic colors (red, brown,.blue, etc.) and tint
(light, medium, dark) as descriptors: 0.� c)-k6ZC LO A u �
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): /VCVtJ
4. Clarity: Choose the'number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
.0 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:
O 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:
2 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
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe A110A1
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year
Individual NPDES Permit No. NCS©®®[6fl©F7] or
Certificate of Coverage (COC) No. NCG❑❑❑❑❑❑
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP.
Facility Name: cLer..""'t L�+CveA�-� _ C" Ll- C
County: R
Phone Number: (toy) q.-5`- YL 7
_ _Total_no. of. SDOs monitored
RECEIVED -
NOV 2 3 2015-----_--
DENR-DEMLR
Land QualitySer'_�
Mooresville Regic"
Outfall No. T
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 to
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 DWO to reduce monitoring frequency ❑
Other ❑ -
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No x
SW U-264-Generic-13Dec2012

1
S

Additional Outfall Attachment
Outfall No.
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ Nox
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ Nox
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
arameuiri
■
F i
!
. -
'a, h°,
'm^�
�3r'
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►r►�T1�9AEMCMM.a.i
FEW a9•
- We M
WE�
SW U-264-Generic-13Dec2012

;'I+certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations."
Signature '> l/ Gy
Date // /6-Zola _
For questions, contact your local Regional Office:
DWO Regional Office Contact Information:
SHEYIL EGtONA U
AYETTEYIL E REGIONAIJ O
OORE$Y LE RE�IO AI. U -
225 Green Street
610 East Center Avenue/Suite 301
2090 US Highway 70
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
tt��
IU ' �� �aI6N'' 0 °
�AL Q r
943 Washington Square Mall
127 Cardinal Drive Extension
3800 Barrett Drive
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
1617 Mail Service Center
Raleigh, NC 27699-1617
[phone]NartCarzifinawairer.:
_NUMB
- endenhanoe5
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
SW U-264-Generic-13 Dec2012

J
STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORI G REPORT (DMR)
Calendar Year 0 1
Individual NPDES Permit No, N
Certificate of Coverage (COC) No. N
or
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP.
Facility Name: 0_ ,e^41,--A C SpU-C..4C7t;s
County: err uS
Phone Number: 7( 9q) -5-- % % % Total no. of SDOs monitored —
Outfall No. D O /
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 Ter 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 D ,
Total
�
'Rainfall,
::rnches
=�
MJ
':
Benchmark
AFIA
0, . p p 73
Loneciea,
mm/.ddiyy,
.11 1 O, Q
rrl
'WISICIV OF L4NU H ,
�'�' S� nON`�
4r^=11fl~n .
DEC 0 3 2014
�� PAh �CJY�- {(�k
CIYVIJ•r
SW U-264-Generic-Mec2012

U- �
�- ,,;
i � ;.�
'+ > i
� ,,.. �1
� S 4✓r w
� � � •�
ti
• � 't
M�
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i
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. ' ,
I l
• �
� �
� f �
� � _
i
{
_,

r
-' Additional Outfall Attachment
Outfall. No. 00,2-
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No
Was this outfall ever in Ter 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
Min
®LLfii�1
EAM
'
r
SW U-264-Generic-13Dec2012

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 possjja(lity of fines and imprisonment for knowing violations."
Signature ti�y!/
Date /Z —2—uly
For questions, contact your local Regional Office:
DWO Regional Office Contact Information:
ASIIEVII;LEREGIONAL:OFFICE I
FAI'ET1'EYIi.I :E'-REGIONAL OFECCE
1VIOORFSYII:LEtREGIONAi::OFFICE
2090 US Highway 70
225 Green Street
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
{ [phone]
RAi EIGH REGIONAEOFFICE
WASHIWQT0N� ZEGIONAL 0_MGE
:WII 14iINGTON REGIONAi.�'OFFICE
943 Washington Square Mail
127 Cardinal Drive Extension
3800 Barrett Drive
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
(919) 7914200
1 [phone]
[phone]
WINSTON=SAEgM=REGIONAI:4FFICE
CENTRAL,O)ICE
1617 Mail Service Center
"To preserve: _ me:
585 Waughtown Street
Winston-Salem, NC 27107
Raleigh, NC 27699-1617
, andenhance
[phone]
[phone]
sg ' Nohh Carofrna'sivarer::
SW U-264-Generic-13Dec2012

RECEIVED
DIVISION OF WATER QUALITY
w
FEB 2 2 2013
STORMWATER DISCHARGE OUTFALI_ (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR) SWP Ses^MN
Calendar Year 24 I L MOORESViLLE REGIONAL OFFICE
Individual NPDES Permit No.
Certificate of Coverage (COC) No.
or
This monitoring report summary of the calendar year is due to the DWO Regional Office no later than March isr of the following year.
Facility Name: Chyi ie&L TA —
County: &r Cu/u -S ��11
Phone Number: (�+4)g5Sr qt� I Total no. of SDOs monitored 0 --
Outfall No. 1
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ Nov
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑• No-K
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 DWO to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No
ara
97.Z>
SW U-264-Generic-25May20i 0

Additional Outfall Attachment
Outfall No. -0—
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No;EQ
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
11M
t7'
• ., .. ..2.'>..
�Ra
.„-e -
i sR. ....:......<fi 'itS?3 _
a.T. x-_ _.
a..z.m
_ .Y�__ .._
i - -..&.. $4
v 1 '0-l'fi 1 a.
SW U-264-Generic-25May2010

I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations."
Signature C:�
Date aZ - o2a -/3
Mail Annual DMR Summary Reports to:
DWO Regional Office Contact Information:
ASHEVMIjgLIREGIONAL OFi fC_, E-
FAYEITEVI LE4EGIONAL.OFFI
MOOR SYI%IsE REGIONAL OFFICE
225 Green Street
610 East Center Avenue/Suite 301
2090 US Highway 70
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
j [phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
RALEIGN REGIONAL:OFFIC-
WASHiNGTON REGIONALOFFIGE
WIGMINGTON REGIONAI. OFFICE
943 Washington Square Mall
127 Cardinal Drive Extension
3800 Barrett Drive
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
i i�VINSTON=SA LEMAEGIONAL-OFFICE
NTRAL O ICE
1617 Mail Service Center
Raleigh, NC 27699-1617
15WI-_T(fiiFe- prorea
and eA.
n)ranoe
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
[phone]
e':caralrnas'water
SW U-264-Generic-25May2010

i'-'- .. _
Individual NPDES Permit No. N
Certificate of Coverage (COC) No. N
STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year Za IS
or
RECEIVED
DIVISION OF V144TER QUALITY
DEC 2 0 2013
MOOREMLLE REGIONAL OFFICE
This monitoring report summary of the calendar year is due to the DWO Regional Office no later than March 1st of the following year.
Facility Name: C.ri� �`aCEr
County: r1-U 1,
Phone Number: (W) y r y/7% _ Total no. of SDOs monitored
Outfall No.
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No
Was this outfall ewer in Tier 2 (monitored monthly) during the past year? Yes ❑ No Un
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 0 No
-'i"3
6 ^.A�4
_
•�
C.
;;::-
.Yg 4$[«v
..Y-+ _
.� '. :
! £� ^T-
..= jE ',Rnwa."F'"N'"r�
-
§� s'
'Y''.. ._ :$. ^..
.may �,�- . ~.
!.. Y --'S' �3.
-- v C.... :.2
_..:A .,
.. •'. ,G, :' .. -s
I
WALAM
1
-_
SW U-264-Generic-25May2010
1

0-
Additional Outfall Attachment
Outfall No. 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?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWO to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No
;:... .: _.' .:Pa"ramete'r;;(units)rs
Totals
•� fTr
-
=;C u
a -
Benchmark
WA
0, 007
0, O (C `l
/ .QO .
/ a C} ..
ip '
'Date.Sample;
< Collected;; -=
0, 075Z
i 9 . a-
AO
7-2G-zod
1,9,3
6.0365-
0,i73
1 N])
1 71 )V
SW U-264-Generic-25May2Q10

" I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations."
Signature
Date t 2 /r 812 o r 3
Mail Annual DMR Summary Reports to:
DWO Regional Office Contact Information:
SW U-264-Generic-25May2010

p
mc_ v 'r Cat'
Stormwater Discharge Outfall (SDO) Monitoring Report & NAIIMAL RESOUlt("93
®fE 31 1998
(all samples collected during a calendar year shall be reported by Jan. 311OWN iF EWY.M. 14141at '5"'�smFiq
Permit No. NCS D Uu U 51 following year_1m wr
�+��"�a"�,lE mom SCE
4ected during calendar year
Lab No. [:!S 1 PrYC�Se .plc 5
Certified Labs.
Lab No.
r'ar[ A:
County C-a-bzrYuS 3
Phone No. 7.0 q 'f 55 6 /9
Signatulie of permitee or Designee
By this signature, I certify that this report is accurate and
cornplete to the best of my knowledge
Page 1 of 2

Does this facility perform vehicle maintenance activities using more than 55 gallons of new motor oil per mon!h? Yes_)�_No
(if yes, complete part B)
Part B: vehicle maintenance activity reporting requirements
footnotes:
t Applies only to facilities at which fueling occurs Mail original and one copy to:
Attn: Central Files
2 Detergent monitoring is required only at facilities which conduct vehicle cleaning operations. DEHNR
Division of Environmental Mgt.
P.O. Box 29535
Storm event characteristics: Raleigh, NC 27626-OSM
(if more than one storm event was sampled)
Date �� Z qi Date
Total event precipitation ( inches) Total event precipitation I inches)
Event duration hoursl Event duration I hours
" I certify under penalty of law that this document was prepared under my direction or supervision. Based on my inquiry this information is to the best of my knowledge
accurate and con lete. ft aware there are significant penalties including fines and imprisonment for knowing violations."
Z<11�1 z-;; /S m
(Signature of perrnitee) c1late
Page 2 of 2

December 14 1998 C81
� GHEMIGAL9PEGIALTIE4, INC. i
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Attn.: Central Files
DEHNR
Division of Water Quality
Storm Water Unit
P.O. Box 29535
Raleigh, North Carolina 27626-0535
Re: Chemical Specialties, Inc.
Permit No. 000057 Storm Water
1998 Storm Water Monitoring Report
Greetings:
Enclosed is our sampling results for pH. The previous sample that was analyzed wasn't
run for pH within the specified time limit.
Sincerely,
i�"r 4-a,�
Tim Renckens
Environmental Assistant (ORC)
704 455-4161
Enclosure
cc: SJB w/ enclosure
PO Box 610_• 5910 Pharr Mill Road • Harrisburg, NC 28075. 704-455-5181
Main 'Fax'704-455-6507 • Purchasing and Transportation Fax [phone]
-455-1940 Lab Fax [phone] • Accounting and PoleCare Fax 704

ANNUAL STORMWATER SAMPLING CHECKLIST
SAMPLER'S NAME Re��
DATE OF SAMPLE
LOCATION OF SAMPLE POINT /
TIME RAIN EVENT BEGAN
TIME OF SAMPLE
TIME RAIN EVENT ENDED Zzh3Z99 �
EVENT DURATION 20 Ar3
TOTAL RAINFALL 9• 4D 411 P" I
TOTAL FLOW DURING EVENT S220 ��nS
(Calculated from area drained)
DATE(S) ANALYSES COMPLETED l IZ �q8
SEMI-ANNUAL VISUAL CHECKS
(One sample in the Spring, one in the Fall)
SAMPLE COLOR
ODOR
CLARITY
FLOATING SOLIDS
SUSPENDED SOLIDS
FOAM
OIL SHEEN
OTHER OBVIOUS INDICATORS
OF STORMWATER POLLUTION
Norte
none
none
June

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
PERMIT NO. NCS OW657 SAMPLES COLLECTED DURING CALENDAR YEAR: M5 - 6N6 5AwrP[
(all samples collected during a calendar year shall he reported no later than �.
January 31 of the following year)
FACILITY NAME 1'1z4EPAu RE501,i4 9 D&ILOPM6< k47f-orJ COUNTY_CA IaK
PERSON COLLECTING SAMPLE(S) DAM DONN PHONE NO.(adq - 1
CERTIFIED LABORATORY(S) WCA&AlL A00)7-OL W S_Lab #
Lab # (SIGN A OF PERMITTEE OR DESIGNEE)
By this signature, I certify that this 'report is accurate
complete to the best of my knowledge,
Part A: Specific Monitoring Requirements _ 1
46,
Page 1 of 2
Form MRNCS

Does this facility perfonn Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? —yes no
(if yes, complete Part B)
Part B: Vehicle Maintenance Activitv Monitoring Reauirements
Out V4�
roD te�
005O"W
�0055fi � � ..� �
0105I
382GEi
ll(14W i �'
�."
Total FlowOel:and
Grease
Yli,ead;Total
Defergents
pH ��M
New Motor OilW.
rSanple
RecoI
MBA S 2
€
# ilsa ge A
,dileCled;
verble
rn.
`x
MG'modd/
6 W T`;:
en
c*)
%.d FootnoitIDL
1 Applie,�onlyr facilities at which fueling occurs.
2 Detergent monitoring is required only at facilities which conduct vehicle cleaning operations.
\STORM EVENT CHARACTERISTICS:
Date ? I 5
Total Event Precipitation (inches): 7
Event Duration (hours):.
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches): '
Event Duration (hours):
Mail Original and one copy to:
Attn: Central Files
DEHNR
Division of Environmental Mgt.
P.O. Box 29535
Raleigh, NC 27626-0535
"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."
(Signatu of Perm-ittee) '(Dad)
Page 2 of 2
« Form MRNCS

R EAR h & ANAlyT CAl
UbORATORIES, INC.
Anaiyt mVPmcess Consoitatjans
Phone (910] 996-21341
CHAIN OF CUSTODY RECORD
WATER►WASTEWATER 1 MISC.
•: •PROJECT
ill jl� I FA FA
IPA 11 1
SAMPLERS (SIGNATURE)
STATION LOCATION
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soon
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NONE
■■■■■■■■
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loss
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UTfjA- - U 0 1 -Lkk&t, cx-76rJ ,t- ro ( { v7-, O �► nw

RESEARCh & ANA1YTICA1
LABORATORIES, INC.
Analytical/Process Consultations
11 December 1995
Chemical Specialties, Inc.
5910 Pharr Mill Road
Harrisburg, North Carolina 28075
Attention: Mr. Paul Miano
Re: Stormwater Monitoring
ANALyT �•.
O;G
NC #34 z:
h I iD AN1%s
Parameter Units Outfall 682 001 1/14 95
TSS mg/l 10 !! Pa
COD mg/l 40
pV Std. TTnJ.ts G . G
Chromium, Total mg/l <0.005
Lead, Total mg/l ¢0.005
Copper, Total mg/l 0.033
Zinc, Total mg/l 1.72
Arsenic, Total mg/l 0.048
Sample Number 256558
Sample Date 11/29/95
Sample Time 0825
mg/1 = milligrams per liter parts per million
= less than or below detection limits
R0. Box 473 • 106 Short Street • Kernersville. North Carolina 27284 • 910/996-2841

9� ��, ���
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