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Part B - Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) [] No p
discharge this eriod2
Outfall
No.
No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Sample Collected)
mo/dd/yr
-
I Total Suspended
Solids
mg/L
100 or SOA
C0530
and
Standard units
6.0 — 9.0
Oil &
Grease,
mg/L
Permit Limit
"
Parameter Code
-
46S29 -
-
Zg
00400
00552
Footnotes from Part A also apply to this Part B
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 II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAMF PARAMETER AT ANY ONE OUTFALL? YES ❑ NO l.g"
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑ CNIO
REGIONAL OFFICE CONTACT NAME:
Mail an on inal CODY Of this DMR includin all "No Discharge" re orts within 30 days of receipt of the lab results or at end o monitoring
eriod in the
case o "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 att chments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evalu a he information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsib! for gathering the inform ion, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are signific nt a alters f�submitti false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Perm
Permit Date: 11/1/2018-5/31/2021
0 /11,8 4A 1) 1
Date
SWU-248, last revised 11/1/2018
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