NCG080210 DMR SW (2)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted 12 - 9 -/
CERTIFICATE OF COVERAGE NO. W-600 SAMPLE SAMPLE COLLECTION YEAR -Z 01 S
FACILITY NAME RG Pk aGI C St;.edlc.izs — G os �i)AG,4,y-n ✓ SAMPLE PERIOD F] Jan -June Q�July-Dec
COUNTY R u R KI✓®��..�, or [] Monthly' (month)
PERSON COLLECTING SAMPLES 1n A Da Goo5I6oys EC I V HARGING TO CLASS ❑ORW ❑HQW []Trout []PNA
LABORATORY PACk AA1A lYrI d A L Lab Cert. # 37 712 . 1/0 DEC 10 z M ❑Zero -flow RWater Supply OSA
Comments on sample collection or analysis: ❑Other
CENTRAL FILES PLEASE REMEMBER TO SiGN ON THE REVERSE -�
DWR SECTION
Part A: Vehicle Maintenance Areas Monitoring Requirements
❑ No discharge this periods
:;OutfOil,
"No;,
Dafie •
amply 6", 4,
nio dd` t'
005$0
00400
Non -Polar Oil! and.448se/TRH EPA;Poethod' _ Total Suspended Solids;k.
1604 (sti7`4Hi );,M L ii► /i...
.1`atat'Suspended.
Solid ;,m /L`
pH;'.
Standard, units
Non�Polar Oil antlGre;�se/TPH EPA New Motor 0 iJs4
Method 1664' 5GT-HIM)'rrt L Agnual,avera e` I%m'o .
lltj„Firi�ar -f
`:
.50 dr.1004ee ermlt :
�tiitliiri 6.0 9:0
15
2
it -30—/S
IV 17
D
I - 30 —16r
0
7,
t7 ---d
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 B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals
Outfall ; :.
Ido,
; ' pat
Sample Collocted,
nio/dd r
:00530.
= 00400
Non -Polar Oil! and.448se/TRH EPA;Poethod' _ Total Suspended Solids;k.
1604 (sti7`4Hi );,M L ii► /i...
pH,
Standard units
Per • It l.iM- tt • '
t- 35 Sd or ld0 see ermit
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 October 25, 2012
Page I of 2

STORM EVENT CHARACTERISTICS:
Date f1-30-15 (first event sampled)
Total Event Precipitation (inches): 3.4/1
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: If you report a sample value in excess of the benchmark, you must Implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mallon orlaina/ and onecoav of this DMR Includlna all "No Discharge" reports within 30*vs of recelat of the lab results for at end of mon torina period in
the case of No Dlscharae" resorts) 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 signific nt pen ties for submitting false Information, including the possibility of fines and Imprisonment for knowing violations."
(Signature of ermittee) (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wa/ws/su/nodessw#tab-4
SWU-250 last revised October 25, 2012
Pase 2 of 2