NCG160082_MONITORING INFO_20190621

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v
flOC TYPE
❑HISTORICAL FILE
Sk MONITORING REPORTS
DOC DATE
❑ C)
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report (DINIR)
for Forth Carolina DEMLR General Pe it a. NCG1G01(�01Q - Asphalt
Date submitted 60 o/
CERTIFICATE OF COVERAGE NO. NCG1614 � � SAMPLE COLLECTION YEAR
FACILITY NAME _ _yMf5' dAkA/eSAMPLE PERIOD 0 Jan -June ❑ July -Dec
COUNTY )A kE E or ❑ monthly' month
{PERSON COLLECTING SAMPLES s&vnr. XAe.01-5, DISCHARGING TO CLASS ❑ORW ❑HCIW []Trout ❑PNA
LABORATORY R Lab Cert. P I' I � � ❑Zero -flow []Water Supply ❑SA
Comments on sample collection or analysis: RECF❑Other
JINN 2 l 2019
PLEASE REMEMBER TO SIGN ON THE REVERSE -�
CENThAL FILES
Part A, Stormwater Benchmarks and Monitoring Results DVVR SECTION
No discharge this period?Z
outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
inches'
Total Suspended Solids
Benchmarks ==_>
100 mg/L or 50 mg/L
o
G-9-/
o
--/
G • /
L�
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Z 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 rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirem?nt.
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, they must be reported in the format, "<XX mf7AL", where XX is the numerical value of the.
detection limit, reporting limit, quantitation limit, etc. in mg/L.
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 next.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
Date Sample
Outfall No. Collected'
Benchmarks ===>
Footnotes from Part A also apply to this Part 6
7-4-hour rainfall
amount, Non -polar O&G by EPA
Inches' 1664 (SGT-HEM)
15 mg/L
No discharge this period ?2
Total Suspended Solids
100 mg/L or 50 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.
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXC.EEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
e TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? 'YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriyinal and one copy of this DMR Includingall "No Dischar e" reports, within 30 days o receipt a the lab results or at end o monitorin period
in the case a "No Dischar e" 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 REPORTFD:
"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
am aware that there are. significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
ezIlP e*/a
(pate)
Permit Date:10/1/2014-9/31/2019
SWU-252, last revised 9/17/2014
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report DMR
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted I o . ,
CERTIFICATE OF COVERAGE NO. NCG16Q ja _1.2,
FACILITY NAME _ 'J�RWAQ ASO�GT R!Aar _
COUNTY
PERSON COLLECTING SAMPLES J F,AUCJ$
LABORATORY ABC - Lab Cert. # 60
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR
SAMPLE PERIOD ❑ Jan -June © July -Dec
or ❑ Monthly' _ (month)
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
❑Zero -flow []Water Supply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE ->
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Total Suspended Solids
Benchmarks =-_>
_
-
100 mg/L or 50 mg/0
28.7 wt l-
No discharge this period?z
RECEIVED
NOV 14 2018
CENTRAL FILES
DWR SECTION,
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Z 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 rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
" 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, they must be reported in the format, "<XX me/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation 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 filer 3 responses. see General Permit text.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
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?z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks
15 mg/L
100 mg/L or 50 mg/0
Footnotes from Part A also apply to this Part 8
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 SINGLE BENCHMARK EXCEEDANCE,TRIGG£RS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES I'N A ROW FOR THE SAMEPA_ (AMETER AT THE.SAME OUTFALL TRIGGER TIER•2•REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES [INO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS*QUIRED BY THi PERMIT?` YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mall an original and one copy of this DMR Including- all _"No Discharge" reports, within 30 days of recut of the lab results (or at end of monitoring period
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:
"I certify, under penalty`of law, that this document and all atfachments 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
am aware that there are -significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations.
�. -(Date)
Permit Date:10/1/2014-9/31/2019
SWU-252, last revised 9/17/2014
Page 2 of 2

r•
Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Pe i o. NCG160000 - Asphalt
Date submitted
CERTIFICATE OF COVERAGE No. NCG16Q O ' Z
FACILITY NAME /f�.Pr m
COUNTY Vi44re_
PERSON COLLECTING SAMPLES S �/iL'rrl�-p
LABORATORY �bfi�L° - Lab Cert. ti
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR AlIr
SAMPLE PERIOD ® Jan -June ❑ July -Dec
or ❑ Monthly' __ (month)
DISCHARGING TO CLASS ❑ORW �HQW QTrout ❑PNA
Zero -flow []Water Supply OSA
Other
PLEASE REMEMBER TO SIGN ON THE. REVERSE -->
No discharge this period
outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspended Solids
Benchmarks ==a
_
-
100 mg/L or SO mg/L
o �
,z,y �v
o, pS
.�S•3 � <
/111
RECEIVED
MAY 14 2018
CENTRAL FILES
DWR SECTION
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 rain gauge. Unattended sites may be 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, Nil, 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, quantitation 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: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

Part 8: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > SS gal of new oil per month.
❑ No discharge this period?z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inchesa
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =_->
_
-
15 mg/L
100 mg/L or 50 mg/0
Footnotes from Part A also apply to this Part S
Note:- !f 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 SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN,A ROW FOR THE •SAME•PARAMETER AT -THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOURFACILITY HAD 4 OR,MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR�REGIONAL OFFICE AS'REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy 9fthis OMR including all "No Discharge" reports within 30 days of receipt of the lob results for at end of monitoring period
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:
"I certify, under penalty of law, that this document and all attachments were preoared under my direction or supervision in accordance with a system designed to
assure that qualified personnelproperly-gather and evaluate the information submitted. Based on m in uir of the person or persons who manage the system, or
4 p B Y p g Y
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that there are -significant penaltiesfor submitting false information, including the possibility of fine; and imprisonment for knowing violations."
Permit Date: 10/1/2014-9/31/2019
SWU•252, last revised 9/17/2014
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report DMR
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted 2 ax /7
CERTIFICATE OF COVERAGE NO. NCG16 Q 2— SAMPLE COLLECTION YEAR 117
FACILITY NAME 1_44�r SAMPLE PERIOD ❑ Jan -June ® July -Dec
COUNTY I or ❑ Monthly' _ (month}
PERSON COLLECTING SAMPLES vS' ��'��-J:I\ rD S HARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY f � '_ Lala Cert. q ,A- g 2�t8 []zero -flow ❑Water Supply ❑SA
Comments on sample collection or analysis: []Other
INFORNATION PROCESSING UNII PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results
❑ No discharge this period?'
Outfall No.
Date Sample
�
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches;
Total Suspended Solids
Benchmarks =__>
_
-
100 mg/L or 50 mg/0
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 rain gauge. Unattended sites may be 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 rport 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 me/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier I, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
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?z
Outfall No.
Date Sample
Collected,
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
_
-
1S mg/L
100 mg/L or 50 mg/L
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 SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO []
REGIONAL OFFICE CONTACT NAME: --
Mail an oriainal and one copy of this DMR. includina all "No Discharge" reports. within 30 days of receipt of the lab results for at end of monitorfna Period
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:
"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)
Permit Date:10/1/2014-9/31/2019
( Date)
SWU-252, last revised 9/17/2014
Page 2 of 2

Semi-annual Stormwater-Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted 7
CERTIFICATE OF COVERAGE NO. NCG16Q Q_ _j _'�7
FACILITY NAME G'�,r/.s'7',(�c>�ior/ aAeAM
COUNTY C✓A45'
PERSON COLLECTING SAMPLES J�� ,,f
LABORATORY ��IG'F _ ~ Lab Cert. # A
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR o�&/ 7
SAMPLE PERIOD © Jan -June ❑ July -Dec
�I��P'_.1❑ Monthly'_ (month}
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout❑PNA
MAY a 9 Z 17 ❑Zero -flow []watersupply ❑SA
❑Other
CENTRAL FILES
DWR SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE -�
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches;
Total Suspended Solids
Benchmarks ===>
-
-
100 mg/L or 50 mg/L
a�
oZ3 17
0.77
43 19
N, 7 2
10
13 17
0.77
7. /
No discharge this period?z
RECEIVED
MAY 0 0 2017
CENTRAL. FILES
DWR SECTION
' 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 rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
° 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, they must be reported in the format, "<XX me(L", where XX is the numerical value of the
detection limit, reporting limit, quantitation 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: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
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?z
Outfall No.
d
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Non -polar O&G by EPA
1664ISGT-HEM)
Total Suspended Solids
Benchmarks =_->
_
-
15 mg/L
100 mg/L or 50 mg/0
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 SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER,1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES []NOR
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" 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:
"I certify, under penalty oflaw, 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 submitti6g1alse'information, including the possibility of fines and imprisonment for knowing violations."
(Signature
Permit Date: 10/1/2014-9/31/2019
T 4/7
(Date
SWU-252, last revised 9/17/2014
Page 2 of 2

Semi-annual.Stormwater Discharge Monitoring Report DMR
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted /"z
CERTIFICATE OF COVERAGE NO. NCG16. j2 f A
FACILITY NAME LW25' L20rf��iQyCT<�✓ la'ARN€R
COUNTY WAKE
PERSON COLLECTING SAMPLES
LABORATORY Lab Cert. ii
Comments on sample collection or analysis:
Part At Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR
SAMPLE PERIOD ❑ Jan June ® July -Dec
or ❑ Monthly' _ (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
[]zero -flow []Water Supply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE ->
outfall NO.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
Benchmarks
100 mg/L or 50 mg/L
D
No discharge this period.AR EC E IV E D
JAIL 0 6 2017
CENTRAL FILES
DWR SECTION
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Z 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 rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
° 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, they must be reported in -the format, "<XX mg/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
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.
Permit Date: 10/112014-9/31/2019 SWU-252, last revised 9/17/2014
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-hour rainfall
amount,
Inchesa
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks
15 mg/L
100 mg/L or 50 mg/0
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 SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR'FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one copy of this DMR, indudlna 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 Resources
Attn: DWR 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."
20/
(Date)
Permit Date: 10/1/2014-9/31/2019
SWU-252, last revised 9/17/2014
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit o. NCG160000 -Asphalt
- Date submitted G 2m�
CERTIFICATE OF COVERAGE NO. NCG16 O 0 T 2- SAMPLE COLLECTION YEAR 044/V
FACILITY NAME Ldy Gr.dS>.�riex�sv li6P,!/6.0 pu�T SAMPLE PERIOD tan -June ❑July -Dec
COUNTY AIM—F or ❑ Monthly'_ _ (month}
PERSON COLLECTING SAMPLES DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY lab Cert. # []zero -flow [_]waterSupply []SA
Comments on sample collection or analysis ❑Other_ _
Alb FI EfAffigft
Part A. Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE
C,-r�
® No discharge this period?'
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches;
Total Suspended Solids
Benchmarks ==_>
_
-
100 mg/L or 50 mg/L
17
O
RECE, �
CENTRAL FILES
DWR SECTIC3R;
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z 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 rain gauge. Unattended sites may be 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, they must be reported in the format, "<XX g/L" where XX is the numerical value of the
detection limit, reporting limit, quantitation 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: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
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Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
n No discharae this neriod?2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches;
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks ===>
_
-
15 mg/L
100 mg/L or 50 mg/L
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 SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW -FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO �]
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copv of this DMR. includina all "No Discharae" reports. within 30 days of receipt of the lob results (or at end of monitorina period
in the case of "No Discharae" 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:
"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
am aware that there are significant penalties for submitting false•information,including the possibility of fines and imprisonment for knowing violations."
(Signat a of Permittee) (Date)
Permit Date:10/1/2014-9/31/2019
SWU-252, last revised 9/17/2014
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