NCG080156_MONITORING INFO_20181127

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NUG D pj Q / E; (p
DOC TYPE
❑HISTORICAL FILE
2( MONITORING REPORTS
DOC DATE
❑ 301 f l a 7
YYYYMMDD

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)1 SPPP Annual Update DATA REVIEW FORM
Calendar Year 2 o W
Individual NPDES Permit No. NC5❑❑❑❑❑❑ or
Certificate of Coverage (COC) No. NCGO®❑0 ©U©
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP.
Facility Name: _ E Ccn±c ✓ - - -
County. (I�.Ilc.-+- --
Phone Number: (9_27 %
Outfall No.y 0 ,1,
Is this outfall currently in Tier 2 (monitored monthly)?
Total no. of SDOs monitored
Was this outfall ever in Tier 2 (monitored monthly) during the past year?
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 7
Was this SDO monitored because of vehicle maintenance activities?
RECEI ED
Yes ❑ No V 2 7 2Qi8
Yes ❑ No
CENTRAL RES
DVVR SEC- 16N
Yes ❑ No
Total
Rainfall,
inches
Parameter,((units)
(S,
0.` I G „c�.tic
' a 1 �-tf
Benchrriark t
+�
l` Y:
�;N/A.��
.... ....#aS.
`p*' dA
� � �k J
=.:i :{Y-_^rs-. -...7 _: ,.
-: `. -
.:
�, � iS � �._
:. s-.-e. .. ,. _rl. .r
C-t ,fF�fr �.1
'!1 .ri r'A�
� r- J 0 ,,.
w-,�. «-Ix s..t_1,
` '"S-P-
f-i
.��. ; . f �
„�.14. �_ _.a.
M;r.i.>rr,-Kr .,'�,,.
1,�:.. � �
_.� USr-
.:•e4-_
Date Sam le
Collected,a
mmldd/YJP07
l_
_
x v 4
a
ry a
t
a F,.
n
.
v�
A14
�� Ai j Q"
d
SWU-264 - Generic Annual DMR
Last revised 5�17/2013

" I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowl
including the pPIS'
Signature
Date //—
and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
ity of fines and imprisonment for knowing violations."
For questions, contact your local Regional Office:
DWQ Regional Office Contact Information:
ASHEVILLE REGIONAL OFFICE
2090 US Highway 70
Swannanoa, NC 28778
[phone]
'r
RALEIGH REGIONAL OFFICE
3800 Barrett Drive
Raleigh, NC 27609
[phone]
WINSTON-SALEM REGIONAL OFFICE
585 Waughtown Street
Winston-Salem, NC 27107 '
336 771 5000
FAYETTEVILLE REGIONAL OFFICE
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301-5043
_ _(9_10) 433-3300 _
WASHINGTON REGIONAL OFFICE
943 Washington Square Mall
Washington, NC 27889
[phone]
- .. --- ------ _.---............... - - -----
CENTRAL OFFICE
1617 Mail Service Center
Raleigh, NC 27699-1617
[phone]
MOORESVILLE REGIONAL OFFICE
610 East Center Avenue/Suite 301
Mooresville, NC 28115
[phone]
WILMINGTON REGIONAL OFFICE
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
_ [phone]
"TD j}re58fVB, {7rC)leCt
and enhance
" Noah Carolina's water. _
SWU-264 '- Generic Annual DMR
Last revised 511712013

* ,h " NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: htW.Ilportal.ncdenr.org/web/irlupdc5-stormwaterL
Permit No.: ��_/_/_/_ /�/_/_/ or Certificate of Coverage No.:
Facility Name: �r� i r►r► Ce+7#��
County:
w« (,t-
Inspector:
Date of Inspection:
Time of Inspection:
Total Event Precipitation (inches): _ I. T �
Phone No. _(4 i co R1`6 -S-7 7 7
Was this a "Representative Storm Event" or 'Measurea=Stormas defined by the permit?
(See information below.)
tA 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 Perrpfttee or Designee)
Page 1 of 2
SwU-242, Last modified 7/31/2013

s W
1. Outfall Description:
Outfall No. Oy ;?, Structure (pipe, ditch, etc.) rP ✓C
Receiving Stream: L+'4+te LiA,4-e C)G(,- Cmc- It -
Describe the industrial activities that occur within the outfall drainage area: F4►�'+ �, �� oacfr ✓+ •+-r c.J
P,j" c4trL detL rti I �,r, IaI� lC4d, �y Pw�►nµYy Inc( clnc(kv� �� wcfe� je�tirc rtJi1 f k jurt 4rui bwr.. b(�J,
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
[light, medium, dark) as descriptors: hetT ( .
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): yrLe- ^�
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 2 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:
O2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 2 0 4 5
7. Is there any foam in the stormwater discharge? Yes No
8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
CUSUf10%.V1j
wr4T— ujc-A _ „rt,kc.A.< look difc'1-'ra 6 red S U 0q"/I a1 A Icia Sig-!I%L -tonIc
ShUv'l� 6- t' jvGnA- nn-A Q'! uU .nrd r�M`dl. 113rl-0u.a- 0Vr.,.-o-Z: d14 cir,rcValor. Wk-e-'k
aSl,40,— (7Arn Wt. &yo.r 4J +o 6,.r. ALt . -ipf-ort-
�(cti ay.a� Gi1[�nnc2 4gin}, 94yrM,,, �< Aledg..
4-o ;, n,,9iffJ !n o Q p c o p e i c k , _
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, fast modified 7/31/2013

Datf-�: o P 6 Iov Cttiem � s r ��
F.My Noma• F, r T d. r t�--
Permit
gn b
Method-
Referrmu�de rear fur i34f �bodsl c M �pFDC�l
Cal. Tune
Calibration )Suffer 4.0
Cah-tff aa E rr 10.0
`Cbwk S ftb, 7.0
Comma
.0
7.ZU
;pH bu&rdmxb are to be within ±d.l pH units of the standards true wine_
4bufferVemdw.. USA- 7hafferVemdor. 11.if) O!NcboQ1L
4 bather Lot#! I� [�-b q 7 buffer LatWL 1 7 D�
4 buffer Esp. Date f 7 buffer Exp. Date f,
10 buffer Veador. Iwo b v 0
f0bafferLow. =rrf4649 _
10 e'er Fap. Date: J t 1 i i
� fl
Sample Collec dov
Tmie♦
SaugAe Analyse
Tim•
T>RItesuh
►I1 Buffer >zvafine
Caar lUataQua3i5©s
r 22 0
IT s+<mpie is exasur ed directly in the strem aadlor oo vO we Cane may be re owded for coDettioo cad ambsis with the notation th* they are named urs�= or at
the Woneffiltely all the =up* site.
► Calibration dnftchwk is requavet when performing aaalystc at mmHRJe samphug Wm6oas (Use Omf er 7,0) mast be within } 0.1 units orthe bps tree "Ime.)
*AA pH remiti is pH anifs (Le, s a.� Report ali data vWom to the nearest 0.1 pH snit
Total Residual Chlorine URC)
Reference Method:' rme4ude year for SM metbedssl S M
Sample Leamon
Uaily Cbeck Stallard
06tainrd V
WL or
'1 eme check
Sonoma
Analyzed
Sau ple
Cron
Time
'Sa> 3pEe
Analysis Tim
TIiC ltesu}t
ILL of
Cow Qa"t�
* If sample is mempnvd directly in the stream and/or ounce, eal}- time aaalyzed weUM be recorded- --
TRC check
Standard standard true
S b (acceptance Tara W 1.'fy ^ l . 7 � mgtL)(t nust r � � withiu *lo% of the tbtck standard's truc yatea)
33 (per) LO&rmenarler a
DPD (6gaW Ia�idead5er ,t/ f-TA Baser solution (5yaid) LoUNdeatt&c, : r
Annual Calibration VerilIcation Carve Date: _ $ 1 2-j F 1 ao r 7 &rL tjt(3 J I P
Reagent Wank Valve: NJ A _ (Analyze and docatoent a reagent blank when standards are prepared in the lab.)
Conductivity
R ferxace Method: rmrcinde veer for SM methods)
ie argent Rk
Cal. Time
Calibration
Std
verificom
Std
Optioml
Std
►Post -Analysis
Drift Cbeck std
Carats
► his a raeammeaded drill clack to be amalyeed when maettipte samp5ne lorrt;oas are mrasered Note: an nnRs are ln►-hasr—
Caoratiou Standard Lat#W4entfti VerIfKatioa Smndard I OUWdemafwr.
Sample Loca6m
T
Cell Cons= s
Collet#iort
Tone
Arratysis
Time
� �
�*
Caste
.ffsample is duectly w thes'trr aml/er ou sib, onty time analyzed weald be recorded.
=F.ahx PIA (net applicable) if aUtoamatic temperature compeanadom aml tc$ c mcaaut are med-
ATC aumaal cheek dam

lacieAnalyfical"
wwnv.pacelabs cm
ANALYTICAL RESULTS
Pace Analytical Services, LLG
6701 Conference Drive
Raleigh, NG 27607
(919)8344984
Project: Fire Training Stormwater
Pace Project No.: 92404988
Sample: fire Training Lagoon Eff Lab ID: 92404988001 Collected: 10/26/18 12:20 Received: 10/26/18 13:00 Matrix: Water
D02
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
1664 SGT-HEM, TPH Analytical Method: EPA 1664B
Total Petroleum Hydrocarbons ND mg1L 4.8 1 11/09/18 05:14
2540D Total Suspended Solids Analytical Method: SM 2540D-2011
Total Suspended Solids 102 mg1L 16.7 1 10/30/18 02:01
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 1110912018 03:54 PM without the written consent of Pace Analytical Services, Ll.C. Page 4 of 11

; ceAna4 tical'
morra.OsrahEs.am
CHAIN -OF -CUSTODY I Analy1cal Request Document
The Chalrof-Cuslony Is a LEGAL DOCUMENT. All reilwant 9dds must bo completed axuratoly.
Section A
Season B
Section C
Page:
of r
Required Ctkont InfQTnBtio;1:
Required P cc% Inlormatton:
Involco lnformallon:
!
Company: , L rs . J
Report To:
SA ►ram
Atten';on:
l7- i �" .!
1786.727
Address: f
CacY To,
CT-
Company Name:
o41
REGULATORY AGENCY
�VCiV L�
r
Address:
r" NPDES r- GROUNDWATER r- DRINKING WATER
Ematt To: C C n Y t P tr- Q
A I+�V i �.,.[ Purrho.e O:dcr No.:
o i 6
Porn Ouew
UST (" RCRA
r" OTNER
Fh0 a: �(� Fax:
fna(<fcl Name: T
' r4 t�'.
f1r� IN �"N-
ny+e ern
PiOa pr"
�tnna
She Location
Rtqucatod Out OatcfTAT:
Prolorl Numbur.
FW
Paw Ntvrl. °:
STATE:
Requested Analysis Flftarad (Y!N)
Section D
Motrla Cade.
Z
MhT13% I GOOF o
COLLECTED
Preservnflves
3-1DnrwLng
Watar
DW p cr
Water
wr tj
-MITE
Wnste Water
Ftaduct
WW .,., m l�4srm
P CT�ftr
CCU
U
cwenm.a U
. _
,
; 1 e�' G' y�twi-
samsolid
Oil
i
St. _
=
>
S ]a r.
SAMPLE ID
L U
V
y
r
(A-Z, 0.4l,-)
Air
AR `L
4
LU
2
m
!
Semplo IDs MUST BE UNIQUE Time
TS Cl M
E
r4 y
N
U
Other
OT U
Y
z e
O � s �
y
�
O
is
JJ
g
z r,Z
a
v DATE
TIME DAT>= TIME
u totO
Pace Project Not Lab I.p.
z
S
4
5
8
7
8
9
1g
tt
1x
ADDITIONAL COMMENTS
RELINQUISHED BY I AFFILIATION
DATE
TIME
ACCEPTED BY r AFFWATIoN
DATE
TIME I
SAMPLE CONOITIONS
C Lvto�,l
►,ice.N-
I 6
30o
CSC% _
o ",t3oa
3
SAMPLER NAME AND SIGNATURE
ORIGINAL
PRINT Name of SAMPLER
1 a4
SIGNATURE of SAMPLER:
—wl'7
DATE Signed
tutamarrrl! I11I,1
'tepenant NDW 6y slgnim this farm yeu are aunpWV YaW's NET 70 aay payrna%wftn and og a "!o rate mvW2 of 1.5%per Inv= for arty Invaces no' wftnin 7c Ct:yi - -

Semi-annual_Stormwater Discharge MonitoringReport
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted (I l�_i a o
CERTIFICATE OF COVERAGE NO. NCGO8 O it 57 6
FACILITY NAME _ �Cr „I e)I V1
COUNTY (nfa (c L
PERSON COLLECTING SAMPLES _ G u tia� 5_ Cc%vv V,
LABORATORY %m . G , C . fr,a Lab Cert. # 0 LfJ -t IO
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR .20I Y
SAMPLE PERIOD ❑ Jan -June ® July -Dec
or ❑ Monthly' (month)
RECEIVED
TO CLASS ❑ORW ❑HOW ❑Trout ❑PNA
11 ►VJ ❑Zero -flow ❑Water Supply ❑SA
NOV 2 7 2018 ®Other
CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CWR SECTION
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes ✓no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
❑ No discharge this period'
Outfail
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit .
Within 6.0 — 9.0
15
-
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 -- 9.0
C7 a
101.2 01F
G
ioa
G,3S
I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date a(. J2 (first ev'ent sampled)
Total Event Precipitation (inches): - / 58,
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: If you report a sample value In excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS, SEE PERMIT PART ii SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mall an oLiglrral and one cop�r of this DMR, in_ cludino all "No Discharge" Aworts within 30 days of receipt of the lab resents (or at end of monftorina period In
the case o "No Discharge' re orts) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATIONREPORTEID:
"I certify, unde,,,..mnajty 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 pmanalties
I properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsgathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that
there are signifl for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature
(Date)
Additional copies of this form may be downloaded at: http-.1/portal,ncdenr.org/web/`wclfwsZsu/npdesswgtab-4
SWU-250
last revised April 11, 2013
Page 2 of 2

Semi-annual Stormwate_r Discharge Monitoring.Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted 1 I g 1 a o I S
CERTIFICATE OF COVERAGE No.. NCG08 O 1 S (o
FACILITY NAME ,,� , rc 1 ins N1r�1 G �GriC�✓ -
COUNTY W�
PERSON COLLECTING SAMPLES C_ �' S Cc&nn.rt
LABORATORY Pa . G.C. fr. a Lab Cert. # 0 Lf u o
Comments on sample co lection or analysis:
SAMPLE COLLECTION YEAR a 0 12
SAMPLE PERIOD N Jan -June ❑ July -Dec
or Monthly'
(month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
RECE IVE —) ❑Zero -flow ❑Water Supply ❑SA
JUL 2 4 201b (Other C
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTV�AL FILES
Did this facility perform Vehicle Maintenance Activities using more than 55 gallonsDo f newEmotor ail per month? _yes ✓ no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
2"No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 6.0 — 9.0
i5
-
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 — 9.0
t For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 1], 2013
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date (first event sampled)
Total Event Precipitation (inches): _
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharae" reports, within 30 days of receipt of the lab results for at end of monitoring Period in
the case of "No Discharae" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"I certify, under penalty ff,hn
at this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personnel ather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible for 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 pensubmitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of
-7111,1"o
(D te)
Additional copies of this form maybe downloaded at: http://portal.ncdenr.org/web/wq/wIsu/npdessw#tab-4
SWU-250
last revised April 11, 2013
Page 2 of 2

Semi-annual_Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted 11 � I a o I X
CERTIFICATE OF COVERAGE NO. NCG08 0 I S 0
FACILITY NAME f~ i rc Trr,� ,� ti �� ni€✓
COUNTY V.--
PERSON COLLECTING SAMPLES
LABORATORY Pn� ` vt,bj.j"J r - Lab Cert. # 0 4 C
Comments on sample collection or analysis: JAN 2 3 -1;;3
SAMPLE COLLECTION YEAR '2O 1 -7
SAMPLE PERIOD ❑ Jan -June ® July -Dec
-or ❑ Monthly' _ (month)
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
❑Zero -flow []Water Supply []SA
®Other _ C--- -
DVVR3EcI ION PLEASE REMEMBER TO SIGN ON THE REVERSE 4
IN FORMATION PRO' ESSING UNIT �
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yes ✓no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 6.0 — 9.0
15
-
J.
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 — 9.0
Uo�
ao
<9,0
',j
1 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Pagel of 2

STORK -EVENT CHARACTERISTICS:
Date Iajavj 12 (first event sampled)
Total Event Precipitation (inches):
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: If you report a sample value In excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART If SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS, SEE PERMIT PART If SECTION B.
• TIER 3. HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR including all "No Dischar e" re orts within 30 days of receipt of the lab results for at end of monitoring period In
the case o " reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"I certify, under penalty of' , that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personnelfi
erly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible farring 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 p for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of
r
l8
(Date)
Additional copies of this form may be downloaded at: http:/Zportal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
S WU-250
last revised April 11, 2013
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted -r l 17 1 a o 12
CERTIFICATE OF COVERAGE NO. NCGQ8 O 1 S (o SAMPLE COLLECTION YEAR a 01 7
FACILITY NAME SAMPLE PERIOD ® Jan -tune ❑ July -Dec
COUNTY or ❑ Monthly' (month)
PERSON COLLECTING SAMPLES Gu; d,. S C�, ,,—VrL DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY K"-V' Lab Cert. # 0 `tor S[ 9 0 ❑Zero -flow ❑Water Supply []SARECEIVED ®Other c
Comments on sample collection or analysis:
JUL 2 1 Z017
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL F LES /
Did this facility perform Vehicle Maintenance Activities using more than motor motor oil per month? _ yes ✓no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
25'No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 6.0 -- 9.0
15
-
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfal I
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 — 9.0
I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
5WU-250 fast revised April 11, 2013
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date (first event sampled)
Total Event Precipitation (inches): _
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS, SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriuinal and one copy of this DMR, including all "No Dischar e" reports, within 30 days of receipt of the lab results or at end o -monitoring period in
the case of "No Discharge" reports) to:
Division of Water Quality T
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personnel, Properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsibl thering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that
there are signifi s for submitting false information, including the possibility of fines and imprisonment for knowing violations."
I V
(Signature of er' ittee) (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
S W U-250 last revised April 11, 2013
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted �a) to l l
CERTIFICATE OF COVERAGE NO. NCG08 D 1 5 G
FACILITY NAME _ Fc�c Tru,Ccn4r-,r
COUNTY W [' i�
PERSON COLLECTING SAMPLES � a3 c. s
LABORATORY Pc,s& nrJ rG.c.,t 3,� Lab Cert. # 04,S I y 0
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR o7 0 ( 6
SAMPLE PERIOD ❑ )an -June July -Dec
or ❑ Monthly) (month)
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
RECEIVED ❑Zero -flow [:]Watersupply ❑SA
f� ��� Other 01
JA
CENTRAL FiLFpLEASE REMEMBER TO SIGN ON THE REVERSE 4
DWR SECTION
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
[✓�No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 6.0 - 9.0
15
-
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 - 9.0
I For sampling periods with no discharge at any single Outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised Aprii 11, 2013
Page I of 2

STORM EVENT CHARACTERISTICS:
Date (first event sampled)
Total Event Precipitation (inches):
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: if you report a sample value in excess of the benchmark, you must Implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART AAND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART li SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMRincluding all "No Discharge" reports, within 30 days of receipt of lab results for at end of monitoring Period in
the case o "No Discharge' reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"I certify, under penalty f law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personnef 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 / hering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that
there are significant hies for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of
I/q/rr7-
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
S WU-250
last revised April 11, 2013
Page 2 of 2

4F
Semi-annual Stormwater Discharge Monitoring -Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted 7 oat i.
CERTIFICATE OF COVERAGE NO. N0008 0 1 _�_ (.z,
FACILITY NAME Ej;t-, Tr'a i rjiN Cen4k.✓
COUNTY Wa (u�T
PERSON COLLECTING SAMPLES &,A i cL, T Co, wa.+-c
LABORATORY a t �...e� v-.c.. ✓ Lab Cert. # 0410 t 51.gi 0
Comments on sample collectio or analysis:
SAMPLE COLLECTION YEAR � D I (o
SAMPLE PERIOD ® Jan -June ❑ July -Dec
or ❑ Monthly' _ _ (month)
��++
DISCHARGING TO CLASS []ORW []HQW [Trout ❑PNA
(RECEIVED ❑Zero -flow ❑Water Supply [_]SA
JUL 21 2016 ®Other. C
CENTFRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE -i
DWR SECTt)1N
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ,_ yes V, or
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable) [�rft discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Giease%TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
50 or 100 see permit
Within 6.0 — 9.0
15
-
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfal I
No:
Date
Sample Collected,
mo/dd/yr
00556
.00530
00400
Non -Polar Oil and Grease/TPH EPA Method ,
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50.or 100 see permit.
6.0 — 9.0
1 for sampling periods with no discharge at any single outfail, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Page 1 of 2

+ STORM EVENT CHARACTERISTICS:
t
Date (first event sampled)
Total Event Precipitation (inches):
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: If you report a sample value In excess of the benchmark, you must Implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mall an orlginal and one copy of this DMR, Including all "No Discharae" reAoits within 30 days of receipt of the lab results (or at end of monitoring period In
the case o "No Discharge" re orts to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personnel p ly 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 t f r 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 pe al E submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of
% /�
(Date)
Additional copies of this form may be downloaded at: http:llportal.ncdenr.org/web/wglws/su/npdessw#tab-4
SWU-250
last revised April 11, 2013
Page 2 of 2

fiT!;1;WF
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filing out this form, please visit: h=:/,/12ortal.ncdenr.org/web/wqlws/suZnpdes,5w#tab-4
pdes,5w#tab-4
Permit No.: �V/� _ f T/_/ _/�/_/_/ or Certificate of Coverage No.:
Facility Name:. jC7--r LS2 117r� (C,i4 v- _
County: Ww Imo- Phone No. &iq)
Inspector: C-1 � , S C',
Date of Inspection: & f g j a 0 Z�2
Time of Inspection: _I y : 3 J
Total Event Precipitation (inches): N 1 A
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.) 11,�
❑ Yes 0 No �' �P e p is �+,4 r +� ��� ��"!1
� JUL 2 z zofs U
Please verify whether Qualitative Monitoring must be perfoSkikrrtu"nay a "representative storm
event" or "measureable storm event" (requirements vary, dep�ngi�'eT,, NF ,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.
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 Peq iittee or Designee)
Pagel of 2
SWU-242, Iasi modified 10/25/2012

U
1. Outfall Description:
Outfall No. 0 0 a- Structure (pipe, ditch, etc.) �O ' P V CG
Receiving Stream: !_.. +4,(,- w Hi -,14- O C, !L C cc
Describe the industrial activities that occur within the outfall drainage area: F, +-r- 4,-%4h I a c-� I U4 dh u
GISSUC1a411 �4-cmS .S"f4 C%eL vGh1-1e'L- wuycten_k4r.fi4V—r4A- m nrnc� tr.�u
LUL. r r%044 rrce% 10 . W. .' 3ct�4r7 Oaf WRd�. crcfp, f�,5uv.11 ar+! bw:+, Lfd�,
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: No o K44-t. (t .�J o , 001.
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): S 4rrc k"�- eA_f- -Pws
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
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 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:
1 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?
10. Other Obvious Indicators ofStormwater Pollution:
1
No
No
Yes No
uqJ:dC.
w ' k '95L d U�w
ay 4'
i Cow�u,nw1 S ow`c� Uc _Pfc�t. ur�4rSkf-1 w -W C%-•4w,.^,.,C�..�w�ra+ S�S,�Iayc
PO"L � rJc,�T o+^' G rr� �(� oN C7 e a�� [�lS ch%':w1 t ` e !
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erasion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SVVU-242, Last modified 10/25/2012

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted i I a a o 110
CERTIFICATE OF COVERAGE NO. NC_G08 O 1 S 6
FACILITY NAME arc TrCCeIfGe-
COUNTY Via ILZ_ _
PERSON COLLECTING SAMPLES
LABORATORY_ Pau J I,,a,<<a . G. c • 1i -,r. Lab Cert. # 0 4 0, Si `i O
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR a () I S
SAMPLE PERIOD ❑ Jan -June Z July -Dec
or ❑ Monthly' (month}
� ;ISCH ING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
REC El v ED ❑Zero -flow ❑Water Supply ❑SA
JAIL 2 5 2016 ®Other C_
CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4 �
DWR SECTION w/no
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes ✓no �
(if yes, report your analytical results in the table immediately below) `
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
[2 No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 6.0 — 9.0
15
-
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 — 9.0
I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Pagel of 2

STORM EVENT CHARACTERISTICS:
Date (first event sampled)
Total Event Precipitation (inches):
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
e A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "'No Discharge" LUorts, within 30 days of receipt of the lab results (or at end of monitoring period in
the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personae rap rly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible f r at ring the Information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that
there are significan p ai es far submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of
r
/7/0
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr,org/web/wq/ws/Su/npdessw#tab-4
SWU-250
last revised April 11, 2013
Page 2 of 2

��
NC®ENR
Stormwater Discharge Qutfall (SDQ)
Qualitative Monitoring Report
Forguidance on filling out thisform, please visit: htt�//Voi-tal.ncdeni-.oi-g/web/wq/ws/sii/nl2dossw#tab-4
Permit No.: lv/C/ _/�/_/_/_/_/�/ or Certificate of Coverage No.: N/C/CE/ 0/-2/ D/L/ S/ b/
Facility Name: Frrc. Trl► .114c (CPA-k-✓ T_
County: We, fA— Phone No. C91g) ?S-6 S77 7
Inspector: _ G,A110 S Carrara
Date of Inspection: (T1 2 o lS-
Time of inspection: l4 i o F ",
Total Event Precipitation (inches): - A/ 1 A
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
'' A/0 OIS ck0, rf
❑ Yes � N a r,'t'
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 Pomittee or Designee)
Page 1 of 2
SWU-242, last modified 10/25/2012

I. Outfall Description:
nutfall No. (90R Structure (pipe, ditch, etc.) (0PVC-
Receiving Stream: 6-, 4-j-U G✓h,.k Oalt C rccJc-
Describe the industrial activities that occur within the outfall drainage area:/1E,; � u sn v-0C' j
QS1QCta'ka y,4i, burn,ny "4".m.i ,S'NC%rvr 0,44(e4- _ LWytfc—.p4d1c4J .etc., Nil��wrr„C �iur� p��nu _[tr✓.F
a4 fMnO KCf,✓-r 401� f►NOV4r� sC�ancfary C9r!' Cntdr. Scfan��fvt fgjwjtiJ 4—t (7urn htlll .
2. Color: Describe the color Mhe discharge using basic colors red, brown, blue, etc. and tint
g g ( )
(light, medium, dark) as descriptors:
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.):
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
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 2 3 4 5
7. is there any foam.in the 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 nutfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
List and describe " NO i s,ary
'11., d ICILf C.E.
du., IL Si hw.Ul p,2-
cJ
!!0
w•s� l�CkOw �.r�f�w
IdCL,Gr4, 1ln�vt W
<.^� frv,., nwrn
hfd�
.L�lh_0
T
h��r c r6G.l 4- a.,s;h
d`
k f„J,.-A -114 dCJOt-�*"
d P'N- :` s
✓�
a r«.4r h c. i r , 0.7r r�..� �. ab}�
� 1 �r„ � uJ� -�,r.� S � r,�+ w.,
c t-. Vfr Q n of- .r t-0g •,
on C..
i
CM`�-rn�rti`�k ar(. 40 x ►'CM0r-'r !^'�
//,��
lJ�41(.0 i"J•�ea. li/V✓G1Y i<-I�fCd�*-{i•
i1�1✓7 VLF✓c.`s
-
/}e Je/4q-Pc
ff
1'.JI^� 1V�'TM
Vc.r•, i a� 14Cif ar.. � wJ'{ .l.E dt 1 J �Gn r
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, bast modified 10/25/2012

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)1 SPPP Annual Update DATA REVIEW FORM
s ' - Calendar Year a 0/5
Individual NPDES Permit No. NCSUUUUUU or RECEIVE[
Certificate of Coverage (COC) No. NCGD®E0© 0
JAN 2 5 2016
This monitoring report summary of the calendar year should be kept on file on -site with the facility_ SPPP.
CENTRAL FILES �
Facility Name: cc„�k r DWR SECTION
County: Wa {�� �+
Phone Number: ! ai4 ) 5116- S 7 7 7 Total no. of SDOs monitored '-
Outfall No. 009.
Is this outfall currently in Tier 2 (monitored monthly)?
Was this outfall ever in Tier 2 (monitored monthly) during the past year?
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 g �®
Yes ❑ No
Yes [-I No[.
Total
Rainfall,
inches
Parameter, (units)
_ .. ..._, :.-e.S":.-r, '
Ben -h
� �m _ - `�.-. ;'�
,:N �.,�.
e :..� ...... � 7f`.� a �Y• �'k�
�-z« •��
f �
� r
� �'.�: �
'.i{S. `fti. )
�,��; .� --:- H �:�
;y.. _F :-:�+:--•
� .��� � s
- ..F
,,°.:,,�-
_{::
, Y_ ,1. �
��
Date Sample
Collected,mmlddlyy
,
W1,
!�
SWU-264 - Generic Annual DMR
Last revised 5/17/2013

' r
_ 7
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
sytem.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 kn
including the
Signat
Date
ajld belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
iljt)/of fines and imprisonment for knowing violations."
For questions, contact your local Regional Office:
DWQ Regional Office „Contact Information:
ASHEVILLE REGIONAL OFFICE FAYETTEVILLE REGIONAL OFFICE
2090 US Highway 70 225 Green Street
Swannanoa, NC 28778 Systel Building Suite 714
[phone] Fayetteville, NC 28301-5043
RALEIGH REGIONAL OFFICE
3800 Barrett Drive
Raleigh, NC 27609
[phone]
WINSTON-SALEM REGIONAL OFFICE
585 Waughtown Street
Winston-Salem, NC 27107
-- -- [phone] -
_(910) 433-3300
WASHINGTON REGIONAL OFFICE €
943 Washington Square Mall 3
Washington, NC 27889
[phone]
CENTRAL OFFICE
1617 Mail Service Center
Raleigh, NC 27699-1617
80776300
MOORESVILLE REGIONAL OFFICE
610 East Center Avenue/Suite 301
Mooresville, NC 28115
[phone]
WILMINGTON REGIONAL OFFICE
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
i - "To preserve, paVeet 1
and enhance
i North Can na's water.__'
SWU-264 - Generic Annual DMR
Last revised 511712013

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted _als 1poT is -
CERTIFICATE OF COVERAGE NO. NCG08 © 1 ,'
FACILITY NAME
COUNTY We, IG
PERSON COLLECTING SAMPLES G A I' c
LABORATORY Pau Lab Cert. # QLf 0 ig_5-( 9 D
Comments on sample collet ion or analysis:
SAMPLE COLLECTION YEAR aO15_
SAMPLE PERIOD Z Jan -June ❑ July -Dec
or ❑ Monthly' _ (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
®Other
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes ✓no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle -Maintenance Areas Monitoring Requirements (If applicable)
70A
Outfal I
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
r
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 6.0 — 9.0
15
-
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfal l
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0,— 9.0
1 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
r®
SWU-250 last revised April 11, 2013
Pagel of 2

CORM EVENT CHARACTERISTICS:
Date (first event sampled)
Total Event Precipitation (inches):
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of period in
the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that his document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personnel pnier/shbmitting
y g her and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible for gag e information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that
there are significant Pena false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Perm
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/weyw-q/ws/­su/npdessw#tab-4
N
SWU-250
last revised April 11, 2013
Page 2 of 2

r
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted -7 I I T f a o is -
CERTIFICATE OF COVERAGE NO. NCGO8 4 1 6
FACILITY NAME rc,.
COUNTY (nJcI<er
PERSON COLLECTING SAMPLES GA
LABORATORYPaL, �,.., .,� C�.c. „,�.K Lab Cert. # OLto10 S 15 0
Comments on sample colle ion or analysis:
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of
(if _yes, report your analytical results in the table immediately below)
Part A: Vehicle -Maintenance Areas Monitoring Requirements (If applicable)
SAMPLE COLLECTION YEAR c201.5-
SAMPLE PERIOD g Jan -June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
®Other C,
I MEMBER TO SIGN ON THE REVERSE 4
4Pyes ,v obi eil�oe�.r pruthj _no
ii11 II ��
ZNo discharge this period'
Outfal I
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 6.0 — 9.0
15
-
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfal I
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 — 9.0
I for sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Pagel of 2

STORM EVENT CHARACTERISTICS:
Date (first event sampled)
Total Event Precipitation (inches):
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART it SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ No ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all. "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in
the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED-
"[ 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 Vrspanel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly re Bible 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 ar ificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
are
-7 <�
(D te)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-250
last revised April 11, 2013
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted 11► a I a 0/
CERTIFICATE OF COVERAGE No. NCGO8 01 S
FACILITY NAME t'+i%� ,�„� C✓
COUNTY W w Icx
PERSON COLLECTING SAMPLES
LABORATORYQw_�,.�. i�a .c. ,. - tab Cert. # 01to 5! 1i c)
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR od 01_
SAMPLE PERIOD ❑ Jan -June ,July -Dec ^
or ❑ Monthly' _ (month)
RECEfV�LBi f6� NG TO CLASS []ORW ❑HQW ❑Trout ❑PNA
❑zero -flow ❑Water Supply []SA
.BAN 2 1 2015 ©other_ ,✓ ^^ _
CENTRAL FILES �='P rA'Sf REil EMIE',ER VO SEA: N C.N.
DWR SECTION �
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _/no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
Er/ml'o discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 6.0 -- 9.0
15
-
Part B; Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 — 9.0
I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring repoi1 with a checkmark here.
SWU-250 last revised April 11, 2013
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date (first event sampled)
Total Event Precipitation (inches):
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: If you report a somple value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
copy _ f p at end o�monitorinct period in
Mail an original and one co a his DMR, including all No Discharge_ reports, within 30 days o rece� t of the lab results (or„ 4 o
the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"I certify, under penalty of law, klat this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personnel VNpeoV gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible fo411
g 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 pr submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Perm
C� 5�
(Date)
Additional copies of this form may be downloaded at: hti :/iDoi,tal.ncdenr.or,�/+Ateb/wg/ws/su/n!)desswt.,cab-4
SWU-250
last revised April 11, 2013
Page 2 of 2

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit. -
Permit No.:
Facility Name: r, iG Trc,hi 'V►
County: ^Tbj�« ire
Inspector: C5-ukd3 S
Date of Inspection: a AG
Time of Inspection: LIT
or Certificate of Coverage No.: N/C/is/ 01 XI U/ 1 /S/ 6/
Total Event Precipitation (inches): A/j ,+
Phone No. (Q )ct) k.Sb — S 7 7 7
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
�1
❑ Yes M No A10 b iS c A
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 fours 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 Perfmittee or Designee)
Page 1 of 2
SWU-242, last modified 10/25/2012

1. Outfall Description:
Outfall No. 00,� Structure (pipe, ditch, etc.) L pUC A
Receiving Stream: L�. 4- -k bi h , 4k 0 ,, [` C rLe Lam _
Describe the industrial activities that occur within the outfall drainage area:
QSS0(In4c- w'--eh h"e- -0 1'�[. J SWk tii q!'4^Joh+� VC{)4ri . vj4?(.yr-n Q'dl /
j C f � �: G I� ,L r..
pour( whrrl.. S4'vc-4 0-+ run�i4 Y`[ctirs� �vaiY. erirrnr G�iv.tiE.,r j k , fn owl 11rwi i7wi.
j 1 C' wn -✓ -i q• "4-, r s
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint br.ij,
(light, medium, dark) as descriptors:
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weals 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:
1 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:
1 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1. 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
S. Is there an oil sheers 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:
Listand describe " N� p al"Ar4i- �I 1, '- Ou C"'11�n elleid &+v-kct; VAT) Skowt4 k.
�_T_Qiccl sf rw�e�K Ckou.L4 �, �b�njJ,rrra-4-v (',)"rcA 1+4v--qX (lrea-
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.
A
Page 2 of 2
SW U-242, Last modified 10/25/2012