NCG140032_DMR_20200529

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGF NO. NCG140 Q 3 ;1
FACILITY NAME: S+O.^ la
SAMPLE COLLECTOR: JWftt
CERTIFIED LABORATORY IC. hl Lab # S a1
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitorine Reauirements
SAMPLE COLLECTION YEAR: 10ao
SAMPLING PERIOP: ❑July -December PqJanuaryJune
COUNTY iunliA
PHONE NO. (709. 1 11191— (mil 5
ADD TO LISTSERVE? ❑YES [:]NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other_
Outfall No.
Date Sample
Collected
(mm/dd/yr OR
NO FLOW)'
(Standard Units)
g/L)
Total
Rainfall°
(In)
In Tier 2
Monthly Monitoring?
(y/n)
# of Months In Tier 2
Sampling
1005
5-19-10
h. I
33
2
9 -a -ao
N
JU
FILES
�W
StCTlO
n1�,.,,,
.� ... �-- �.� �.+��_, _��«� NU rwrr of NODISCHARGE for each outran 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. Ter 2
Monthly sampling shall be done until consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HOW, Trout, and PNA waters where they are 50 mg/I.
C For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 8/1/2017-6/30/2022 Last Revised 07/27/17
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ft--b n. v..a.:..1.. wAw:w4wwww..n A,-+enr'.*.. AAnrni*^tine Qa,t Arn„r,on+e fnr fariiitiae i icing ni- SS cal of new meter oil/month- averaged over a calendar vear
1"a1 L Q. YGIIWiG
Outfall
No.
IrIQilILC 1 sag ibf-. f-%{,16.Vf16y
Date Sample
Collected
(mo/dd/yr)l
nw... w....(y
pH
(Standard
Units}
Non -Polar
Oil & Grease LzIng
method 1664
Sh HEM
(mg/0
v--
Total
Suspended
Solids
-- ----- ------- --
Total
Rainfall°
(in}
• - -
New Motor Oil Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(Y/n)
# of Months in Ter 2
Sampling2
6-92
152
100Z3
HAS YOU4 FACILITY HAD 4;OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NOX
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑ ;.
REGIONAL OFFICE CONTACT NAME:
Mail Oriainal and one coov 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 Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTEb.
"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 t at there are significant peK.A nal fo submitting false information, including the possibility of fines anlaoao
imprisonment for knowing violations."
s aq
(Signature of Permitt(Date)
Permit Date: 8/1/2017-6/30/2022 Last Revised 07/27/17
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PROCESS WASTEWATER —Semi -Annual Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATEOFCOVERA END.NCGI4O 03-a
FACILITY NAME:
SAMPLE COLLECTOR:
CERTIFIED LABORATORY: Lab #
Lab #
uMrrVIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: 126
SAMPLE PERK D: uly-December anuary-June
COUNTY:
PHONE NO.: (7bii
ADD TOLISTSERVE? ❑YES ❑NO EMAIL
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout[VOther G_
OPTIONAL INFO:
Outfall No.
Date Sample
Collected'
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD?
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mt/L)
Non -Polar
Oil & Grease
using method
1664SGT-HEMP
(mg/L)
Discharge
Duration
(minutes)
Total Flow
(gallons/day)7
-
-
6_93,4
300
53-
.s a
O
r1i0
r {
a
02
CEN
Rf\L
DVV
If wastewater systems have not discharged in this quarter — report "No Flow' or No Discharge' here. Please make sure to mark the sample quarter above.
' Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DEMLR RO staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
Permit Date: 8/1/2017-06/30/2022 Last Revised 07/27/17
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5 TSS limits are 20 mg/L for wastewater discharges to HQW waters,10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater, but
instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
' Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 70,10 Flow as per 15A NCAC
02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DEMLR. If the permittee cannot obtain a
Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DEMLR, and the DEMLR Regional Office may require an annual flow report on
a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR AT END
OF MONITORING PERIOD IN CASE OF "NO FLOWI TO:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED.
"I certify, under penalty of law, ttlatthis 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 subm!#Wg f se information, including the possibility of fines and imprisonment for knowing violations."
(Signature Permittee) (Date)
Permit Date: 8/1/2017-06/30/2022 Last Revised 07/27/17
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