NCG080775_MONITORING INFO_20170119

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO. IVC�
DOCTYPE ❑HISTORICAL FILE
V5 MONITORING REPORTS
DOC DATE aol� Ql l
YYYYM M D D
r

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
CERTIFICATE OF COVERAGE NO. NCGO 0775 y �0 L/ � 15 SAMPLE COLLECTION YEAR 2016
FACILITY NAME Speed a#8 — Rockv Mount NC SAMPLE PERIOD ❑ Jan -June ® July -Dec
COUNTY., Pender Count or ❑ Monthly' --(month]
PERSON COLLECTING SAMPLES Sam Calloway, Mid -Atlantic Associates IS' GING TO CLASS ❑ORW ❑HQW [:]Trout❑PNA
�
LABORATORY ESC Lab Sciences Lab Cert. # 375 �t: ❑Zero -flaw ❑Water Supply ❑SA
Comments on sample collection or analysis: JAN 19 2017 ®Other Class C. NSW
CENTRAL FILES PLEASE 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 X 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
Outfall No. 1
1 12/13/2016
1 <5.560
93.800
7.4
STORM EVENT CHARACTERISTICS:
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 Iasi revised April 1], 2013
Page 1 of 2

Date 12/13/15 (first event sampled)
Total Event Precipitation (inches): 0.31
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 Z, 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 I I 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" reportslto:
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 submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
R I (3 avl
(Date)
Additional copies of this form may be downloaded at: http:ZZportal.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 7po
for North Carolina Division of Water Quality General Permit No. NCGO80000
rJ�5 Date submitted 01/6/16 CIP
CERTIFICATE OF COVERAGE NO. NCGO8080775 SAMPLE COLLECTION YEAR-20tir Uji
FACILITY NAME WilcoHess #396 Rocky Point SAMPLE PERIOD Jan -June x July -Dec
COUNTY Pender or ❑ monthly" month ��
PERSON COLLECTING SAMPLES Jay Baker_ DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA U400
LABORATORY R&A Lab Cert. #34 Comments on sample collection or
analysis: RECEIVED
f n []zero -flow ❑Water Supply ❑5A
x Other —class C;Sw
JAN 13 WE PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL FILES
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of netVp�TWTgo*onth? _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 Collecte
mo/dd/yr
-• -00530
00400
00556 .
Solids, mg/L .
..
pH,-
Standard units
Nan -Polar Oil and (fease/TPH EPA
Method 1664 (SGPHEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark-,'
50'or io6see permit.:.
�. Within 6.0 --9.0
_; . 15
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals jlf applicable)
OutfaII
No...
� bate
Sam Ie Collected,
p_
- ma/dd/yr
x V 00556
- 00536
00400
Non Polar Oil a id Grease jTP gEPA Method
,..
1664 SG,T+EM m /C
- ------------------
Total Susp g d`Nd Solids,
m /U. _
pH,
Standard units
Permit Limit '
y:.:- �,
;15
100 see. permit
6.0 — 9.0
SDO #1
12/20/2015
<5.0
7.8
8.5
' 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
11'age I of 2

STORM EVENT CHARACTERISTICS:
Dale 12/20/1S (first event sampled)
Total Event Precipitation (inches):.12
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 ANYONE OUTFALL? YES ❑ NO x
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 monitoring period in
the case of "No Dischar e" re arts 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 penalti s f submitting false information, including the possibility of fines and imprisonment for knowing violations."
Lynne Hays for Speedway LLC/A.T. William_ _s_ Oil Company 01 6 16
(Signature of Permittee) (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

14 Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date. submitted 07/30/15 �-^—
CERTIFICATE OF COVERAGE NO CCTP O 0 �' 5 SAMPLE COLLECTION YEAl320TI
FACILITY NAME WilcoHess #396 Rocky Point SAMPLE PERIOD x Jan -June July -Dec
COUNTY Pender or ❑ Monthly'_ _ _ (month)
PERSON COLLECTING SAMPLES Jay Baker_ pECEC
iDARGING TO CLASS ❑ORW ❑HQW [:]Trout❑PNA
LABORATORY R&A Lab Cert. #34 Comments on sample collection or 4 ❑Zero -flow ❑Water Supply ❑SA
analysis: AUG Q 3 2015 x other class C;Sw
CENTRAL FILES PLEASE 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
p.
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,
mofdd/y�
00556
00530
00400
Non -Polar Oil and Grease/TPH..EPA Method
1664 (SGT-HEM), mg/L
Total Suspended56lids;
mg/L'
pH,
Standard units
Permit Limit .
-
15
100.see permit
6.029:0
SDO #1
06/24/2015
<5.0
92.0
7.30
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 I I , 2013
Page I of 2

ST6f Ml EVENT CHARACTERISTICS:
Pete 06/24/15 (first event sampled)
Total Event Precipitation (inches):.19
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 ANY ONE OUTFALL? YES ❑ NO x
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 o the lob 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 submitting false information, including the possibility of fines and imprisonment for knowing violations."
Lynne Hays for A.T. Llk Oil Company
(Signature of Permittee)
07 30 15
(Date)
Additional copies of this form may be downloaded at: htt portal.ncdenr.org web w ws su/n�dessw#tab-4
S W U-2S0
last revised April 11, 2013
Pagc 2 of 2

1„
Semi-annual Stormwater Discharge Monitoring Report 8c8lve,
for North Carolina Division of Water Quality General Permit No. NCG080000 JAN 1 4 2015
Date submitted 12/20/14 CPA,
CERTIFICATE OF COVERAGE NO.
FACILITY NAME WilcoHess #396 Rocky Point
COUNTY Pender
PERSON COLLECTING SAMPLES Jay Balser_
LABORATORY R&A Lab Cert. #34 Comments on sample collection or
analysis:
SAMPLECOLLECTION YEAR 2 � 7DwR SECFiLES
CO (1 7iON
SAMPLE PERIOD Jan -June
/x July -Dec
or ❑ Monthly'_ (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
x Other class C;Sw
PLEASE REMEMBER TO SIGN ON THE REVERSE„
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,!---:
Standardrunits
Non-Polar'Oil and Grease/TPH EPA
Method.1664 (SGT-HEIVI); mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100ssee 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
0053.0
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
100 see permit '
6.0 — 90'
SDO #1
12/20/2014
<5.0
7.8
8.5
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 I of 2

STORM EVENT CHARACTERISTICS:
Date 06/20/14 (first event sampled)
Total Event Precipitation (inches):.12
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 EXCEEDANCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO x
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one cop�of this DMR, inch al! "No Discharge" reports, within 30 days of receipt of the lob results Lor 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 submitting false information, including the possibility of fines and imprisonment for knowing violations."
Lynne Hays for A.T. Williams Oil Company 1/9 15
(Signature of Permittee) (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 1 1, 2013
Page2of2

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Data
CERTIFICATE OF COVERAGE NO. NCG08080775 SAMPLE COLLECTION YEAR 2013
FACILITY NAME WilcoHess #396 Rocky Point JUL 2 1 2014SAMPLE PERIOD xJan-June July -Dec
COUNTY Pender CENTRAL FILES or ❑ Monthlyl month
PERSON COLLECTING SAMPLES Jay Baker_ DWQIBOG DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY R&A Lab Cert. #34 Comments on sample collection or ❑Zero -flow ❑Water Supply ❑SA
analysis: x Other —class C;Sw
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
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
C-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
a -
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
fro..
.'Date
'
Sample Collected,
mo/dd/yr
00556 • •; .:
00530
00400:., .
Nan-Polar`Oil and Grease/TPH EPA Method .
1664 (SGT-HEM), mg/L
'Total Suspend ed•Solids,
mg/L
"pH,
Standard units
Permit Limit
-
15
100 see permit
6.0 — 9.0
SDO #1
06/20/2014
<5.0
79.0
7.3
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 06/20/14 (first event sampled)
Total Event Precipitation (inches):.38
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 EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO x
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 o "No Discharge"' re orts)to:
Division of Water Quality
Attn: DWQ Central Fifes
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 submitting false information, including the possibility of fines and imprisonment for knowing violations."
-AZA-
Lynne Hays for A.T. Williams Oil Company 7 17 14
(Signature of Permittee) (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/w /ws/su/npdessw#tab-4
S W U-250
last revised April 11, 2013
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG080000
CERTIFICATE OF COVERAGE NO. NCG08 O�
11
FACILITY NAMIa. -Q t I
PERSON COLLECTING SAMPLES ✓
CERTIFIED LABORATORY I,ab #
Lab #
SAMPLES COLLECTED DURING CALENDAR YEAR: �� Z
(This monitoring report is due at the Division no later than 31) days from
the date the facility receives tlse s piing[resulJ� from the laboratory.)
COUNTY T 2V
PHONE NO. ( U)`1 0
PLEASE SIGN ON THE REVERSE -->
Part A: Vehicle Maintenance Areas Monitoring Requirements
Did this facility perform Vehicle Maintenance Activities wing more than 55 gallons of new motor oil per monih? _ yes _no
(if yes, report your analytical results in the table immediately below)
Outfall
No.
Date
Sample Collected,
mo/dd/ r
00530
00400
00556
Total Suspended Solids,
m r/L
pH,
Standard units
Within 6.0.— 9.0
Oil and Grease,
In
30
New Motor Oil Usage,
Annual average allmo
-
Benchmark
-
100
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH. you mint implement Tier 1 or Tier 2 responses.
See General Permit text.
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals
Outfall
No.
Date '
Sample Collected,
molddl
00556
00530
Total Suspended Solids,
/L
00400
pH,
Standard units
Oil and Grease,
Permit Lintit
30
100
6.0 — 9.0
STORM EVENT CHARACTERISTICS:
Date IN-2,1 (first event sampled)
Total Event Precipitation (inches): 5
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Mail Original and one copy to:
Division or Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
S W U-250-102107
Page 1 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
,AAL PERMIT NO. NCG080000 _
,ATIFICATE OF COVERAGE NO. NCG08
FACILITY NAME JAJ. 1 *55
PERSON COLLECTING SAMPLES 2Y
CERTIFIED LABORATORY EY]\111VOG ►!V, _ Lab #
Lab #
SAMPLES COLLECTED DURING CALENDAR YEAR: 20 -2—
(This monitoring reports due at the Division no later than 30 days from
the date the facility receives the mpli g results from the laboratory.)
COUNTY %V1
PRONENO.Cq&j
PLEASE SIGN ON THE REVERSE 4
Part A: Vehicle Maintenance Areas Monitoring Requirements
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)
Outfall
No.
Date
Sample Collected,
mo/ddl r
00530
00400
00556
Total Suspended Solids,
TZ&
pH,
Standard units
Oil and Grease,
m
New Motor Oil Usage,
Annual avers a Vmo
Benchmark
-
100
Within 6.0 — 9.0
30
-
Note: 1f you report a sampled value in excess of the benchmark value, or outside the benchmark range for ply, you must implement Tier 1 or Tier 2 responses.
See General Permit text.
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals
Outfall
No.
Date
Sample Collected,
moldd/ r
00S56
00530
00400
Oil and Grease,
m
Total Suspended Solids,
m
pH,
___.Standard units
Permit Limit
-
30
100
6.0 — 9.0
STORM EVENT CHARACTERISTICS:
Date 3' 3 (first event sampled)
Total Event Precipitation (inches):_��
Date _ (li5t each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Mail Original and one copy tn:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
SWU_250-102107
Page 1 of 2