NCG140423_MONITORING INFO_20200124

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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v L/
DOC TYPE
0 HISTORICAL FILE
C1WONITORING REPORTS
DOC DATE
Ela oa� a �
YYYYMMDD

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT No. NCG140000
FACILITY NAME: Yff
PERSON COLLECTING SAMPLES /
CERTIFIED LABORATORY Lab #
Lab #
OPTIONAL INFO:
Part A: Stermwater Monitorine Renoirernents
SAMPLING PI; D:
COUNTY
PHONE NO.
ADD TO LISTSERVE7 ❑YI
DISCHARGING TO CLASS:
09 ' /�
y-December ❑ January -June / 10
NO EMAIL:
h ❑HQW ❑PNA ❑Trout ❑Other,
Date Sample
Collected
Outfall No. (mo/dd/yr OR
NO FL0W)'
pH
(Standard
Units)
TSS Event
Duration
(mg/L)
{minutes]
Total
Rainfall°
(in)
In Tier 2
Monthly # of Months In Tier
Monitoring? 2 Sampling2
(y/n)
- -
5-9
-
10e,ED
-
- -
"r
J N 2 4&T
CENTRAI Pit C.
WR SECTt N
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.
! f cl Vd I= ib il I excess a f ti Pe bM 16-1 it I eark, ar uutsfdu the berachmark F4FIge (fUl PH), YUU MUbt iMpIeFFIERt the Tier 1 or I ler 2 responses In the General Permit. TILsr 2
Monthly sampling shall be done until 3 consecutive samples are belowthe 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 SO mg/I.
°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
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Part 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]'
PH
{Standard
Units)
TPW using method
1664ASGT--HEM
{mg/L)
TotagSuspended
ds
/L)
Event
Duration
(minutes)
)
Total
a
Rainfall
m
(')
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
ii of Months
InTier2
2
5arnplin
6-9
15
100 '
-
-
-
-
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEED ES 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 (including all "No Flow" & "No Dischame" reports) within 30 days of receipt of sample (or at end of monitorine 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 CERTIFICATIO(y( FOR AiVY I FOIE RMATION 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 p e i
ng
re of
information, including the possibility of fines and i prisonment for knowing violations."
/—
(Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

TOTAL PRECIPITATION
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dailyUrections: Enter on -site
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