NCG120103 DMR SW (2)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water CQuality General Permit No. NCG120000
Date submitted
CERTIFICATE IFFCOVERAGE NO.-NCG12 0'L 6-3
FACILITY NAME_ 72ftR.1iwJ Zoy,✓fy 1-44 NdX 1/
COUNTY �072VA7i670
PERSON COLLECTING SAMPLES Tlla.� Q,' �a�,:✓Jo�
LABORATORY P,y✓ige4mew A 1 Lab Cert. # iA
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR e26 -IS.
SAMPLE PERIOD RJan-June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
RIME® I❑Zero-flow [✓](Vater Supply [:]SA
FES 0 3 2015
CENTS FILES
DWR SECTION
Other .4),5'- _7V
PLEASE REMEMBER Tl0'S�1GN ON THE REVERSE
U No discharge this period?2
Date Sample - 24-hour rainfall
Outfall No. Collected' amount,
a Chemical Oxygen.Demand . Fecal Coliform' Total_ Suspended Solids
(mo/dd/Yr) Inches. eg
Benchmarks.120 mg/L. 1000 count.per 100 mL 100 mg/Lor 50 mg/L°
:3.
e
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for thie same param
eter at the same outfall.
Z For sampling periods with no discharge at any single outfall; you,must still submit this discharge monitoring report; with a checkmark here.
3The total precipitation must be recorded using data from an rain gauge. Unattended sites may be eligible
n for a waiver of the rain gauge requirement.
., . See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits; -they must be reported in the format. "<XX mg/L"! where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
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.
Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012
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Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?2
Date Sample X 24-hour rainfall r
Outfall No 1 t .
llected amount, Non-polar_O&
3 Total Suspended Solids pH
(mo/dd/yr) Inches; EPA --1664 (SGT-HEM)
Benchmarks =__>. - r 15 mg/L 100 mg/L or.50 mg/L4 6.0 - 9.0 SU-
�
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, Tier12, or Tier 3
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 SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE -YOU CONTACTED -THE DWQ--REGIONAL.OFFICE? YES ❑:NO`❑' . - - -
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for -at ena c
in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail'Service Center 1, • ..s?; ; jf :++�
Raleigh, North Carolina 27699-1617 ; PA
"I certify,,under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system'desgned to
assure that qualified personnel properly gather and evaluate the'information submitted. Based'on;my inquiry of the person o i 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 (here 'are' significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature Permittee) (Date)
Permit Date: 11/1/2012-10/31/2017 ,_ SWU-248, last revised 10/25/2012
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