NCG090028_MONITORING INFO_20191216

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCG Oq O (� at b
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ I I
YYYYMMDD

for No
Semi-annual Stormwater Discharge Monitoring Report
rth Carolina Division of Water Quail y G neral Permit No. NCG
Date submitted 020 /
CERTIFICATE OF COV RAGE NO.�NCG090 0 t�
FACILITY NAME —/�^—L o S i ✓GS
COUNTY ,, nl uJ /
PERSON COLLECTING SAMPLES, (04 4l I i
LABORATORY knyi ro iroeK44 CYJP*N' Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
090000
SAMPLE COLLECTION YEAR -:
SAMPLE PERIOD ❑ Jan -June July -Dec
or ❑ Monthly' (month)
RECEISCHARGINGTOCLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero-flo., ❑Wat r Supply ❑SA
DEC 16 2019 [I Other > �5
CENTIitL FILE'- PLEASE REMEMBER TO SIGN ON THE REVERSE 4
DWR SECTIO?'
Total event rainfoll3 n No discharge this period?'
- Outfall No.
Date Sample Collected'
(mo/dd/yr)
Total Cadmium4,
mg/L
Chromium III, Total
Recoverable,
mg/L
Total Lead,
m L
g/
pH,
Standard Units -
Total Suspended Solids4,
m L
Benchmarks
_
0.003 or 0.002
0.905
0.075
6.0-9.0
100 or 50
Parameter.Cade
-
01027�
C0034 -
01051
00400
C0530
DO /
100 /nl
. o .,, L
z p,o L
• A9
.7 wt t.
00 —
Z j
O,OO
0 rN G
U q L
0 3 S{q pl a n
2 p
< Odd
0/AcL
Q.D M
D
L
< 9,00 L
CrQ.O Z-
0 L
Z&
27, SL
Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
45ee General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2018-05/31/2021 SWU-255, last revised 11/1/2012
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hourrainfall,
amount,
Inches'
Non -polar Oil and
Grease,
mg/L
Total Suspended Solids'
mg/L
New Motor
HydraulicOil
c OOil
Usage,
gal/mo
Benchmarks
_
-
15
100 or 504
Parameter Code
- -
46529
00552
C0530
NCOIL
Footnotes from Part A also apply to this Part B
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ®—
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR including all "No Discharge" reports within 30 days of receipt of the lab results (or at end of monitoring period in the
case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submljting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Permittee
Permit Date: 11/1/20V
Date
SWU-255, last revised 11/1/2012
Page 2 of 2