NCG140354_MONITORING INFO_20140724

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
IVYb 36�
DOC TYPE
❑HISTORICAL FILE
�2 MONITORING REPORTS
DDC DATE
❑Aolq o-7Q�
YYYYMMDD

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
tjC[1�r+035,t-
CERTIFICATE OF CO ERAG E NO. NCG14_Q Q QL o
FACILITY NAME: _ `n C1�nwAl . RAC M. ` . C�
PERSON COLLECTING SAMPLES''ILA
CERTIFIED LABORATORY 1 Lab # 3 17 76o
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
RECEIVEID
SAMPLE COLLECTION YEAR: _20 t t{ JUL 2 4 2014
SAMPLING PERIOD: ❑ July -December [January -June CENTRAL FILES
COUNTY .;�nd lgon _ OWO/BOG
PHONE NO. } -
ADD TO LISTSERVE? ❑YES [�JKIO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA []Trout EjjOtherC.
Outfall No-
Date Sample
Collected
(ma/dd/yr OR
t
NO FLOW),
pH
(Standard
Units)
-
TS5
(mg/L)
Event
Duration
(minutes)
Total.
a
Rainfall
(in}
In Tier 2
.Monthly ":`
- Monitoring?•
(Y/n), .
# o{Months in Tier'
x
2ySampling
6-97
160 2,3
t
i
O
ENY
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
Z if a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/i, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I.
° For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
EIVED
24 2014
AL FILES
/BOG
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

AGIM*
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: http://portal.ncdenr.orgf web/wglws/sti/ni2dessw#tab-4
Permit No.: or Certificate of Coverage No.:
Facility Name: Wn P T?,ago,,_p�
County; .1AeAAffP—to,3 Phone No. 82.9
Inspector: duet-q, FC
Date of Inspection: 2 1 IO I Z OiLl
Time of Inspection: Ito' ts.
Total Event Precipitation (inches): . 3
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
® 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 Permittee or Designee)
Page 1 of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
outfall No. i Structure Cpipe, ditch, etc.)
Receiving Stream: S�2- CIPPA& "
Describe the industrial activities that occur within the outfall drainage area: 3A0AAs4 M:
C OraC fCG.�_��C .lti; of
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(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 0 3 4 5
S. 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:
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:
7
8.
1 ® 3
is there any foam in the stormwater discharge?
4 5
Yes
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 of Stormwater Pollution:
List and describe
�t'.
Yes
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, Last modified 10/25/2012

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