NCG140105_DMR_20200306

STORMWATER DISCHARGE OUTFALL (SDO) - Semi-Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
1
CERTIFICATE OF COVERAGE NO. NCG14 . d SAMPLE COLLECTION YEAR: ,Z02.0
(a
FACILITY NAME: An-4D5 d SA- t-`C-- SAMPLING PERIOD: July-December January-June
PERSON COLLECTING SAMPLES �I24$ Takes.y COUNTY,�fZ )
_
CERTIFIED LABORATORY �vvw4u.rT / Lab# /& PHONE NO. (1—) 6•37-'-t 1 SS'
Lab# ADD TO LISTSERVE? OYES NO EMAIL:
OPTIONAL INFO: DISCHARGING TO CLASS: SA EHQW ❑PNA ❑Trout ❑Other
Part A:Stormwater Monitoring Requirements
Date Sample In Tier 2
pH Event Total Collected TSS Monthly #of Months in Tier
Outfall No. (Standard Duration Rainfallo Monitoring? 2 Sam lin 2
(mo/dd/yr OR Units) (mg/L) (minutes) (in) P B
NO FLOW)1 (Yin)
- - 6-92 1002'3 - - - -
/ 3-4- zo 8.4 , 8.5-- /20 /
RECEIVED
JUL 14 2020
DE\IR-LAND QUALITY
STOR( WATER PERMITTING
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.
2 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.
`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 Date of last pH meter calibration: 5-6 -2"17 Last Revised 7/13/11
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using>55 gal of new motor oil/month—averaged over a calendar year.
In Tier 2
pH TPH using method Total Suspended Event Total New Motor Oil tt of Months
Outfall Date Sample o Monthly
(Standard 1664A SGT-HEM Solids Duration Rainfall Usage in Tier 2
No. Collected g/ ) (minutes) (in) (gal/month)Units) (mg/L) ( p.
(mo/dd/yr)' m L (g al month) (y/ ) Sam lingz
n
6-92 152 1002'2 - - • - -
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL(INCLUDING VEHICLE MAINTENANCE)? YES ❑NOYI
HAVE YOU CONTACTED THE REGION? YES ❑NO Zr
��
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this DMR (including 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 r ons dire tly responsible for gathering the information,the information submitted is,to the best of my knowledge and belief,true,accurate,and complete. I
am a at r re significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations."
' f
740
(Signature Permittee) (Date)
Permit Date:7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2