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Part B: Vehicle Maintenance Activitv Monitoring Reauirements for facilities using> 65 gal of new motor oil/month — averaged over a calendar vear.
Non -Polar Oil &
In Tier 2
Outfall
Date Sample
PH
Grease using
Total Suspended
Event
Total
New Motor Oil
Monthly
# of Months in
No.
Collected
(Standard
method
Solids
Duration
Rainfall,
Usage
Monitoring?
Tier 2
(mo/dd/yr)2
Units)
1664 SGT-HEM
(mg/L)
(minutes)
(in)
(gal/month)
(y/n)
Sampling'
(mg/L)
6-92
152
1002,3
N/A
*Vehicle Maintenance Not Performed at this Locatio
HAS YOUR FACILITY HAD 40R MORE BENCHMARK EXCEEDENCES AT ANYONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copv of this DMR (including all "No Flow" & "No Discharge' resorts) 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. I am aware that
there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
(Date)
Permit Date: 8/1/2017- 6/30/2022 Last Revised 7/27/18
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