NCG020513 DMR SW

4 ANNUAL SUMMARY DMR - STORMWATER
SEND TO CENTRAL OFFICE*
STORMWATER DISCHARGE OUTFALLS (SDO)
GENERAL PERMIT NO. NCG020000
*Report ALL STORMWATER Monitoring Data on this form (including No Flow and No Discharge and Permit Limit Violations) by MARCH 1 of each year.
CERTIFICATE OF COVERAGE NO. NCG02 3
FACILITY NAME: /'/O I'r L ,�,�zoCrNr9 GRr3N�--rE �.
PERSON COLLECTING SAMPLES W6.5 o'T'TS
CERTIFIED LABORATORY K c Lab # 34
Lab #
Part A: Stormwater Monitorine Requirements
SAMPLE COLLECTION YEAR: d - 5 -
COUNTY,
COUNTY RECEIVED
PHONE NO. (-;,L)
ADD TO LISTSERVE? YES ❑ NO 0 EMAIL: MAR 15 2016
CENTRAL FILES
Date Sample
Outfall Collected
No. (mo/dd/ r OR
y t
NO FLOW)
In Tier 2
Monthly .
Monitorin g'
(y/n)' .
# of Months in
Tier,2 "
Sampling'.
'.,;
= Total Suspended
Total Flow
(MG) Solids
y ,'(mg/I)
a
Turbidity
(NTU)
Settleable
Solids (ml/t).
Total
Rainfall
(in)
Event
Duration
(minutes)
100 3,4
See Footnote',
0.1
-��-/S
O
<5.0
.. 1 v 1J1J1 11A1�VL, L ,l1Al iVv "l "vv ul 1VV Lji3uriAn JL' for eacnoutrau nere ana the nate xange.
2 Per NCG02: Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
3 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.
a TSS benchmark values are 100 mg/l except in ORW, HWQ, trout, and PNA waters where they are 50 mg/1.
5 The discharge shall not cause an instantaneous measurement of the turbidity of the receiving water to exceed: -10. NTU for freshwater streams, lakes, and.reservoirs designated
as trout waters; 25 NTU for all lakes and reservoirs, and all salt waters; 50 NTU for all other streams and surface waters. Turbidity may be monitored at the SDO.
Alternatively, the permittee may choose to monitor turbidity in the receiving water, directly upstream and downstream of the SDO.
Permit Date: 1/1/2010-12/31/2014 Last Revised 01-21-11
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Part B: Vehicle Maintenance Activitv Monitorine Reauirements for facilities n0nu ,> 55 oal of nPw mntnr nivmnnth
Date Sample . In Tier 2 ..
Outfall Collected Monthly
No.
(mo/dd/yr OR. Monitoring.
1
NO FLOW) (y/n)
# ofMonths
in Tier 2
Sampling Z
; New Motor
Oil Usage
al/month
Total Flow TPH using method
(MG) `1664A'SGT HEM.
G.=t
! ' (m )
Total Suspended pH Total Event
Solids (Standard Rainfall Duration
(m /1).. Units) (in) (minutes)
: 153:
1003. 6-93
J=2te-!5
<5.0.
$.t
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
WHO AT THE REGION HAVE YOU SPOKEN WITH?
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW" "NO DISCHARGE" & LIMIT
VIOLATIONS) BY MARCH 1 OF EACH YEAR TO:
Division of Water Quality
Attn: DWQ 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, 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 .
vinlatinne ), i ;f
(Signature of
Permit Date: 1
10-12/31/2014
zk
(Date)
Last Revised 01-21-11
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