NCG140249_MONITORING INFO_20180103

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v
DOC TYPE
0 HISTORICAL FILE
�2 MONITORING REPORTS
DOC DATE
❑ 3 0 I p OI p3
YYYYMMDD

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year 2017
*Report ALL STORMWATER monitoring data on this form (include "No Flow'?'No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG 140249
Facility Name: Southern Concrete Materials — Hayesville Plant
County: Clay
Phone Number- ( 828) 253-6421 Total no. of SDOs monitored 1
Certified Laboratory ETA Lab # 600
- Lab #
Stormwater Discharge Outfall (SDO) No. 1 VMA Outfall? Yes ❑ No
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No
Was this outfall ever in Tier 2 during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Outfall No.
Total Rainfall, .
iriches
Total
Suspended
Sol4ds={lTSS)`
II' -
pN, 1
3
SU
06h-061arO&G ,
': (EPXMethod : RP
.',
1fifi4 SGT HEM ,F,
(, })
(VMA}}
.. lfapplicable
`
F
,- New`Motor Oil
IJsa e
! g (gallmo.]
lfappllcable
I -
Sformwater
Benchmarks
!ndlcate NO FLOW If
applicable
Circle Benchmark
1 LOIJO
J
6.0-9.0
1
>55 gallmo. average requires TSS and
Non -polar
Date Sample
Collected,
malddl r
06/30/2017
No flow
12/31/2017
No flow
Permit Date 8I112017 — 6/30/2022
Last Revised 8-22-2015

• _ " Certificate of Coverage No. NCG 14 FO®©P
CERTIFICATION
"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."
[Required by 40 CFR §122.221
Signature
Date 0,
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct - Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 8/1/2017 — 6130/2022
Last Revised 8-22-2015

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCC3140000
CERTIFICATE OF COVERAGE NO. NCG14 0
FACILITY NAME: �� h �f n ��, r !e Le
PERSON COLLECTING SAMPLES 6 1,4'3a
CERTIFIED LABORATORY , _ Lab # (I U
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: /
SAMPLING PERIOD: ❑ July -December [✓]January -June
COUNTY t /4
PHONE NO. C 4)
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA []Trout 20ther��
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
pH
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total o
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling2
-
-
6-92
1002,1
V
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.
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.
a For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

if
P✓$rt B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
[mo/dd/yr}1
pH
[standard
Units]
TPH using method
IE64A SGT-HEM
[mg/L]
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
Rainfall a
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
[y/n}
# of Months
in Tier 2
Sampling'
6-92
152
1002,3
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this DMR Oncluding all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample or at end of monitoring period
in _case of "No Flow") 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
am aware that there are si scant penalti or submitting false information, including the possibility of fines and imprisonment for knowing violations."
l� JY
{Signature of Permittee (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2