NCG080387_MONITORING INFO_20151204

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STaRMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑HISTORICAL FILE
B-WONITORING REPORTS
D06 DATE
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted
CERTIFICATE OF COVE GE NO. NCG08QO O
FACILITY NA E 43
COUNTY
PERSON COLLECTI ��S11ALl/1yA��I11 E5 �
LABORATORY JY�— Lab Cert. 0
Comments on sample collection or analysis:
Part A. Vehicle Maintenance Areas Monitoring Requirements
SAMPLE COLLECTION YEAR In
d
SAMPLE PERIOD ❑ Jan -June my -Dec
or ❑ Monthly`_ (month
DISCHARGING TO CLASS OORW ❑HQW ❑Trout OPNA
[]Zero -flow ❑Water Supply ❑SA
RECEIVED ❑Other
DEC 0 4 2015 PLEASE REMEMBER TO SIGN ON THE RE -VERSE �
CENTRAL FILES ❑ No discharge this period'
DWR SECTION
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 10 see permit
Within 6.0 -- 9.0
i5
-
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
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
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWtJ-250 last rtxviscd Ooobe: 25, 20;2

STORM EVENT CHARACTERISTICS:
Date /+ - r-r (first event sampled)
Total Event Precipitation (inches): -
Date (fist 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 RESULT S:
• 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 OtITFALI.? YES ❑ No ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an original and one cony of this DMR, including al! No Discharge" reports, within 30 days of receipt ot the lab results (or at end of monitoring period in
the case of _`No Discharge" rgeorts) to:
Division of Water Quality
Attn: DWO Central Files
1617 Mail Service Center
Raleigh, North Carolina 27G99-1617
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 asignificam Nejf,alties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
ISIgnature of Permittee)
12
(Date)
Additional copies of this form may be downloaded at: lit lvI/purtal.ncderar.or web w ws su 1tPI4sswtftaEJ
SWtJ-250 1a:1 revised Deloper 25, 20!2
fare 2 u1 2

CERTIFICATE OF
FACILITY NA E
COUNTY '31t
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
NO. NCG08 CC)
PERSON COLLECT
PLES
LABORATORY C_n_ Lab Cert. #
Comments on sample collection or analysis:
Date submitted _
SAMPLE COLLECTIO EAR
SAMPLE PERIOD Jan -June ❑ July -Dec
or ❑ Monthly' (month)
Mom DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
RECEIVED ❑Zero -flaw ❑Water Supply ❑SA
JUN 2 9 ZU15 ❑Other
Part A: Vehicle Maintenance Areas Monitoring Requirements
CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4
DWR SECTION ❑ 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
-
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
Outfal l
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
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 October 25, 2012
Page of 2

STORM EVENT CHARA RISTICS:
Date (first event sampled)
Total Event Precipitation (inches):
Cate (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 It 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" re orts within 30 days of receipt of the lab results or at end ot monitoring eriod 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 forAbmittirlIg false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Perr?iiittee)
�b ' I✓
(Date)
Additional copies of this form may be downloaded at: http://partal.ncdenr,org/web/wq/ws/su/iii)dessw4tab-4
S W 1J-250
last revised October 25, 2012
Page 2 of 2