NCG080334_MONITORING INFO_20180220

A SIB . .
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
(V C b 3 3 7
DOC TYPE
❑ HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ fl��
YYYYMMDD

WC14?2)
FE._ V 3 MB
C I``<FILES
Semi-annual Stormwater Discharge Monitoring ReporCVAk SE-CTION
for North Carolina Division of Water Qual'ty General Permit No. NCGO80000
Date submitted 119
CERTIFICATE OF COVERAGE No. NCGOH O SAMPLE COLLECTION YEAR
FACILITY NAME rJ 'C- `i 'Ns TON SAMPLE PERIOD ❑ Jan -June , luly-Dec
COUNTY / or ❑ Monthly' /month)
PERSON COLLECTING SAMPLES DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY r=IVC D Lab Cert. # ❑Zero -flow {Water Supply []SA
Comments on sample collection or analysis: ❑Other TT
Tiv,
PLEASE REMEMBER TO SIGN ON THE REVERSE �
Part A: Vehicle Maintenance Areas Monitoring Requirements
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
-
L�
D
�O
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
No.
Date
Sample Collected,
mo/dd/yr
00556
00S30
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
' For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a cherkmark here.
SWU-250 last revised October 2.5. 2011
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STORM EVENT CHARACTERISTICS:
Date (first event sampled) t
Total Event Precipitation (inches): `
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 1, 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 FORTH SAME PARAMETER AT ANYONE OUTFALL? YES ❑ N079
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ No ❑
REGIONAL OFFICE CONTACT NAME:
M1 all 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 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 sig ' penalties o ting false information, including the possibility of fines and imprisonment for knowing violations."
9/1
(Signature of Permittee) (Date)
Additional copies of this form may be downloaded at: htt _ _ _2itjtl.ncdenr_o��ewd `n-s sujnpdes:wtttag_q
list revised Uclnher 25. 2012
SWU 25o Pace 2 of 2