NCG210192_MONITORING INFO_20190107

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT N0.
/v uc, a to j 9a
DOC TYPE
❑HISTORICAL FILE
�F MONITORING REPORTS
DOC DATE
❑ O'101 q ml D `7
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina DE MLR General Permit No NCG210000
Date subml tted
CERTIFICATE OF COVERAGE NO NCG21 D / q Z_ SAMPLE COLLECTION YEAR 8
FACILITY NAME AlleI �N<i r � _ SAMPLE PERIOD ❑ Jan -June 0 July -Dec
COUNTY ✓ic or ❑ Monthly" (month)
PERSON COLLECTING SAMPLES /�l«N y't✓ _ DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY v4 )c �a Lab C rt # NG cell' '1/:O e ❑Zero -flow ]Water Supply ❑SA
Comments on sample collection or analysis NG'W Gca1-tt- 3-77%S' RECEIVED ❑Other
JAN 0 7 2019 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CEN r IAL FILES
Part A Stormwater Benchmarks and Monitoring Results (Monitoring is requir(FdfoRly_;iftheltaplity stores exposed accumulations of sawdust, wood chips,
bark, mulch, or other similar material on site for longer than seven Q) days )
❑ No dischorge this period?'
Outfall No
Date Sample
Collected'
{mo/dd/yr]
24-hourmrainfall
aount,
(mount
Chemical Oxygen Demand
Total Suspended Solids
Benchmarks =__>
_
-
120 mg/L
100 mg/L or 50 mg/L4
tqvff�)l
1 -1 -1
/ i 8
.ZS-
Z -14 L
11
-1 1�
1,1ly
2 9'
71,313 ,M L
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here
3The total precipitation must be recorded using data from an on -site Train gauge Unattended sites maybe eligible for a waiver of the rain gauge requirement
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies
Note Results must be reported in numerical format For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format When results are below the applicable limits, then must be reported in the format, "<XX m /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 8/1/2018-7/31/2023 SWU-245 last revised 8/6/2018
Page 1 of 2

Part B Vehicle Maintenance Area Monitoring Results only foir facilities averaging > 55 gal of new oil per month
❑ No discharge this period
Outfall No D to Samp,% 24-hour rainfall
`P amount, Non -polar O&G by EPA
Inches; 1664 (SGT-HEM) Total Suspended Solids
Benchmarks =__> - 15 mg/L 100 mg/L or 50 mg/L4
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
o 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 i
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
in the case of "No Discharge" reports) to
Division of Water Resources
Attn DWR Central Files
1617 Mail Service Center
Raleigh North Carolina 27699 1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED j
"l 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 Perm
/Z -3i-/0�y
(Date)
Permit Date 8/1/2018-7/31/2023 SWU 245, last revised 8/6/2018
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO NCG210000 � ID COLLECTED DURING CALENDAR YEAR �ZO/ 5
EG CERTIFICATE OF COVERAGE NO NCG21 j❑O�© his onitoring report is due at the Division no later than 30 days from
DEC
4tle detnthe facility receives the sampling results from the laboratory }
FACILITY NAME A GENTRAL FILES COUNTY iJ / e__ _
PERSON COLLECTING SAMPLES rt ✓ R W10N PHONE NO ( ) yg S��S lxf 3
CERTIFIED LABORATORY Lab # N L�
_AW't 1!j E-r Ga f Lab # L 0 W Gef i- h 3775. PLI, A -,F MGN ON I IM RLX EKI, N 4
Part A Specific Monitoring Requirements° �Ph NG 0090 j
Outfall
No
Date
Sample Collected,
mo/dill r
Total Rainfall,
inches
00530
00400
00340
Total Suspended Solids,
m
pH,
Standard units
Chemical Oxygen Demand (COD),
m
Benchmark*
-
-
100
Within 6 0 -- 9 0
120
ZZ�• 1
7,5'pCr
n %
/ �/ryF
f
Y 67
`Monitoring is required only if the facility stores exposed piles of sawdust wood chips bark mulch or other similar material on site for longer than seven (7) days
If the facility elects not to monitor because accumulated material is removed within seven (7) days or less, the certification below must be signed The facility shall
also record and maintain a log in its SPPP (Stormwater Pollution Prevention Plan) of dates when material is generated and removed, how and by whom
*Note If you report a value in excess of the benchmark value or outside the benchmark range (for pH), you must implement Tier I or Tier 2 responses in the General Pernut
Facilities that do not store exposed (either exposed to incident precipitation or exposed to stormwater run on) piles of sawdust, wood chips bark, mulch or other similar material for
longer than seven (7) days on site may so certify, and the requirement for analytical monitoring may be waived For those facilities that qualify for the analytical monitoring waiver, the
discharger shall sign the following certification statement
Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit requirement for
analytical monitoring I certify that to the best of my knowledge and belief no piles of sawdust wood chips, bark, mulch or
other similar materials were stored exposed (either to incident precipitation or to stormwater run on) for longer than seven (7)
days before removal since filing the last discharge monitoring report
f its/ n y 50 r✓
Name (Print name)
Title (Print title)
Signature)
/J-.23 -i5J
(Date)
S WU-245-072808
Page I of 2

DID THIS FACILITY PERFORM VEHICLE MAINTENANCE ACTIVIES USING MORE THAN 55 GALLONS OF NEW MOTOR OIL PER MONTH, ON
AVERAGE, IN THE CALENDAR YEAR-'
❑ Yes ❑ No (If yes complete Part B)
Part B Vehicle Maintenance Activity Monitoring Requirements
Outfall
No
Date
Sample Collected,
mo/dd/yr -
00400
00556
00530
Total Rainfall,
inches
New Motor Oil Usage,
Annual average gal/mo
pH,
Standard units
Oil and Grease,
mg/L
Total Suspended Solids,
mg/L
Benchmark*
-
-
-
6 0 — 9 0
30
100
*Note If you report a value in excess of the benchmark value, or outside the benchmark range (for pH), you must implement Tier 1 or Tier 2 responses in the General Permit
Mad original and one copy to
Division of Water Quality
Attn Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
S OU MUST SIGN I HIS C1 R71TICA I ION FOR 1NY L`1� OR1tAT1ON REPOIt FED IN P kit iS A %ND/OIR 13
"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 X am aware that there are significant penalties for submitting false information, including the
possibility of fines and imprisonment fqr knowing violations "
(Signature of Permittee)
(Date)
SWU-245-072808
Page 2 of 2

3
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO NCG210000 RECE)Xgo COLLECTED DURING CALENDAR YEAR
CERTIFICATE OF COVERAGE NO NCG21 OQQR]© JAN 12'Wbonitoring report is due at the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory )
FACILITY NAME CENTRAL FILES 1
R SECTION COUNTY �av
PERSON COLLECTING SAMPLES i PHONE NO Ua e) 9 o
CERTIFIED LABORATORY t Lab #yyD
Lab # N u1 4- 3-77 Jr PLE 1SE SIGN ON I IIE RLN I-RIN , 4
Part A Specific Monitoring Requirements'
elf' uc�, 00909
Outfall
No
Date
Sample Collected,
mo/dd/ r
Total Rainfall,
inches
00530
00400
00340
Total Suspended Solids,
m
pH,
Standard units
Chemical Oxygen Demand (COD),
m
Benchmark*
-
-
100
Within 6 0 — 9 0
120
-i
, 5zCIE
z
d
s
`Monitoring is required only if the facility stores exposed piles of sawdust wood chips bark mulch or other similar material on site for longer than seven (7) days
If the facility elects not to monitor because accumulated material is removed within seven (7) days or less the certification below must be signed The facility shall
also record and maintain a log in its SPPP (Stormwater Pollution Prevention Plan) of dates when matenal is generated and removed, how, and by whom
*Note If you report a value in excess of the benchmark value or outside the benchmark range (for pH) you must implement Tier 1 or Tier 2 responses in the General Perrrut
Facilities that do not store exposed (either exposed to incident precipitation or exposed to stormwater run on) piles of sawdust, wood chips bark mulch or other similar material for
longer than seven (7) days on site may so certify, and the requirement for analytical monitoring may be waived For those facilities that qualify for the analytical monitoring waiver the
discharger shall sign the following certification statement
'Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit requirement for
analytical monitoring I certify that to the best of my knowledge and belief, no piles of sawdust, wood chips bark, mulch or
other sirrular materials were stored exposed (either to incident precipitation or to stormwater run on) for longer than seven (7)
days before removal since filing the last discharge monitoring report'
Name (Print name)
PIS-wl-
Title (Print title)
(Signature) (Date)
S WU-245-072808
Page I of 2

DID THIS FACILITY PERFORM VEHICLE MAINTENANCE ACTIVIES USING MORE THAN 55 GALLONS OF NEW MOTOR OIL PER MONTH, ON
AVERAGE, IN THE CALENDAR YEAR-7
❑ Yes ❑ No (If yes complete Part 13)
Part B Vehicle Maintenance Activity Monitoring Requirements
Outfall
No
Date
Sample Collected,
mo/dd/yr -
00400
00556
00530
Total Rainfall,
inches
New Motor Oil Usage,
Annual average gallmo
pH,
Standard units
Oil and Grease,
mg/l,
Total Suspended Solids,
mg/L
Benchmark* `
-
-
-
6 0 — 9 0
30
100
*Note If you report a value in excess of the benchmark value, or outside the benchmark range (for pH) you must implement Fier I or Tier 2 responses in the General Pemut
Mad original and one copy to
Division of Water Quality
Attn Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
1 OU lIi 1S7 SIGN 7 IIIS CERTITICA I ION I'OR tN V INIa ORMA1 ION REPOIZ FED 1N P iRTS A 1NDIOR 13
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a X " 4
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 fQr knowing violations " M12
(Signature of Permittee)
(Date)
SWU-245-072808
Page 2 of 2