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Home My WebLink AboutNCG080198_MONITORING INFO_20181219STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT N0. /v cc,Q � O DOC TYPE ❑HISTORICAL FILE MONITORING REPORTS DOC DATE YYYYMMDD Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted CERTIFICATE OF COVERAGE NO. NCG08_D 1 76 FACILITY NAME L1 5� TPUCK)tj G, rj c- COUNTYATv_S78 N PERSON COLLECTING SAMPLES 51"y4az LABORATORY 1)4Cr_- 'AN4L a( 6qL —Lab Cert. # Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR jOi� SAMPLE PERIOD ❑ Jan -June [] July -Dec I or ❑ Monthly' &oU (month) DISCHARGING TO CLASS [:]ORW [:]HQW [:]Trout EjPNA RECEI Nif t7- 1- [] Zero -flow DWaterSupply ❑s D.4 DEC 19 2018 [NOther- CENTRAL F:11 E` PLEASE REMEMBER TO SIGN ON THE REVERSE D',AfPx [:] No dischqrge this period' iL"0ut all: !:N . ... .......I Op e99'd, r " n i • Sapddunis,� % M eMethod dd 16 4-(T-, -1h gj- .3 .-. pyqrage;gall encMatk`�t%� ibb s in 9. :L L 1 14- 71 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _"es —no (if yes, report your analytical results in the table immediately below) Part B.- Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals Outfa ."..:Sarrio. ec e ei,Cjdl1 t 'd.-'`-':--;'!N b d/yr 7 V U u,'_ . ..... T. H�E'P Pn�1?6 arDW:6 d Grease 'I -1664�,' 1th 9 c.Total'Sus ended 'd Solids P d its! ermitUftlit', .5 qrll. .,,see permit, A For sampling periods with no discharge.at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SW'U-25r Ir -wised' r 25, 2012 ., %, . --. Papae 1 of 2 i STORM EV1 .;.' CHARACTERISTICS: ? Date I/ is (first event sampled) Total Event Precipitation (inches) Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): 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 If SECTION B. • 2 EXC£EDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS, SEE PERMIT PART II SECTION B. w TIER 31 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES' Q NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an odf final and one copy of this DMR including all "No Discharge" re arts within 30 days o recei t of the -lob results or at end of monitoring period in the case of "No Discharge" rel2ortsr 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 gather' the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are si&nlficapt per ' s for submitting false information, including the possibility of fines and imprisonment for knowing violations." . of Z,7 o? U (Date) Additional copies of this fora may be downloaded at: http://portal.ncdenr.org/web/w-q/wslsu/npdessw#tab-4 SWU-250 last revised October 25. 2012 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted CERTIFICATE OF COVERAGE No. NCG08 0 L a 2, FACILITY NAME — ZllX lelRue.,46, T7 COUNTY . 4 6L -so r-, - - PERSON COLLECTING SAMPLES LABORATORY— Lab Cert. # Comments on sample collection or analysis: Part A-, Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR )0 9 RECESAINIGEOPERIOD Cian-tune Oluly-Dec . or [:]Monthly'--- OCT-, (monLh2 DEC 1 RIS'C"H"ARGING TO CLASS E]ORW []HQW oTrout E]PNA CEN'TfKAL Fil E1- [:]Zero-flow [:]Water supply SA Sz- (1- Ti C- []Other PLEASE REMEMBER TO SIGN ON THE REVERSE -> f719 No discharge this period' LZN '0 1 -6116 --d . ... ... -To, ended 'S'i I'd s g `p an.agpgq ` d� -To. . Epk. ;;Mdthb'd' 1nnua.: 01 ayqr :iM Iffdjith- ffi"a`flk"' it Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? - yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals 0,0Utfs p t -d'--;' e,-.C'6'Ilec e d V. :tv QS56-. 00 :N- on-,Pd atiOw-', .1 1irit �'GetaseTPH! RA ---S so r-5o ids'':'S-aM ta U e 6i �jp . .. ... 5 taftdardAdni :Permit .,seepermlt For sampling periods with no discharge.at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-25r, Ir -tvised" 25, 2012 Pace 1 of 2 5 STORM EVI±.: f CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): Date _______(list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): (Vote: 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 If 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 EXCEEDANCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one cape of this DMR, includingall "No Dischargre"reports within 30 days of receipt o the-lab-results_L at end of monitoring period in the case o "No Discharge" re orts 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 proPA 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 gath6rin4 the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are Anlfcafit pes fol subrylitting false information, including the possibility of fines and imprisonment for knowing violations." re of P L (Date) Additional copies of this form may be downloaded at: http://Portal.ncdenr.org/web/w�q/w---s/su/`nodessw#tab-4 S WU-250 last revised October 25.2012 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted CERTIFICATE OF COVERAGE No. NCG08 0 L � FACILITY NAME L-1 54 7- COUNTY (,.-) - ZUCKI I�G, INC2 ,j 56 PERSON COLLECTING SAMPLES LABORATORY Lab Cert. # Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR �o I � RE SAMPLETERIOD 0 Jan -June D July -Dec CE, izu . or F] monthly' :jrPT, 'month) DEC I EIDOCHARGING TO CLASS [:]ORW [:]HQW [:]Trout [:]PNA CENTRA. []Zero -flow []WaterSupply EISA L iz MA,IR iLEC, [:]Other PLEASE REMEMBER TO SIGN ON THE REVERSE --> N No discharge this period' :.!,.OQ530 T p H 6i6 T 'Von Polar 0 'd'G' -�wORtPA"" rt. "`h'e`W'dat -fi.`Lpjj,;!� 0 ...... .... - ffi d/f i44i�of Annual!; -0i s�irng Standa"rd�u units Methdd m 9q::gMnq Benchmark -_; y e - mt se �pg 'W.i in; i Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? - yes _no (if yes, report your analytical results in the table immediately below) Part B; Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals No Eii,Ulhnte�d, L4 0 40 N6fi. �Viat;Oi A'Gr TPH: PkMei Method ko "'p- 9�q. M Suspended 5, 10e'r` M'if 5 ee.ptirml wo For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SW-U-25r IF -tvisedr25,2012. ti Paize 1 of 2 i STORM EVr;:,' CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier Z 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 11 SECTION B. Y 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART If SECTION B. e TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES4 ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mall an original and one copy of this'DMR, including all "Na Discharge" reports, within 30 days of recelat of the'lab results (or at end of monitoring period in the case of "No Discharge" regorts) 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 gath 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 penajti s fo sub4tting false information, including the possibility of fines and imprisonment for knowing violations." of Permittee) (Date) Additional copies of this form may be downloaded at: http,://portal.ncdenr.org/web/wqws su n dessw#tab-4 SWU-250 last revised October 25. 2012 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted CERTIFICATE OF COVERAGE No. N0008 0 FACILITY NAME 11,5g 7 ga cgl f VC 4 AJf, COUNTY. -A�T�o-t-j. PERSON COLLECTING SAMPLES LABORATORY Lab Cert. # Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements ,,SAMPLE COLLECTION YEAR ,,SAMPLE PERIOD ❑ Jan -June ❑ July -Dec DEC 19 "18 . or ❑ monthly'_ /W61 (month) DISCHARGING TO CLASS DORW []HQW []Trout OPNA CC-14TRAL FiLE2! EIZero-flow EjWater Supply [:]S"'A DIMR E]Other PLEASE REMEMBER TO SIGN ON THE REVERSE —> X No discharge this period1 N S - pH rOrland Grease' TPFI EPA.t New toe,..0 . -U I Solids, mg- Sia'nd i .0nPoa Methbd`1�04'L.(SGZ.H EM)1�' 6 rd: m pjj!uq. .1.00 see pp r. rn j t 9�O --V Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? - yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals 0�iitfali ---,No Sample Collected, ... .... bs� 66�30 1!Nmp P. 9/. L 'Iota' Suspended Solids; rri g/ pit St d' s: .ermMLiniit' For sampling periods with no discharge,at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 'r 25, 2012 SWU-25r, I;, --wised Paae 1 of 2 i • STORM EVES.,' CHARACTERISTICS: i Date (first event sampled) Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): � Note: If you report a sample value in excess of the benchmark, you must implement Tier .1, Tier z, 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 SAME PARAMETER AT ANYONE OUTFALL? YES ' 0 NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy o this DMR, including all "No Discharge" reports, within 30 days o receipt oi`the-lab results Lr at end o}monitoring �erlod_in the case of "No Discharge" reports)- to: Division of Water Quality Attn: DWQ Central.Files 1617 Mail Service Cdnter. 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 gather' the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are signIfican# penq�tie for subrpitting false information, including the possibility of fines and imprisonment for knowing violations." . (Signature of Permittee Additional copies of this form may be downloaded at: http://portal.ncdenr.org/webLwg/ws/sunodesswf#tab_4 S V,U-250 last revised October 25. 2012 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG080000 Date submitted CERTIFICATE OF COVERAGE No. NCGO8 C7 19, a FACILITY NAME L) S;4 TkucKiN6, / A—ic COUNTY PERSON COLLECTING SAMPLES LABORATORY � - Lab Cert. 4 Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR ,2018 SAMPLE PERIOD D Jan -June ED July -Dec . or N Monthly; -JLtLV (month) DISCHARGING TO CLASS DORW []HW [:]Trout [:]PNA []Zero -flow Dwater supply E]SA E]Other PLEASE REMEMBER TO SIGN ON THE REVERSE —> FI-1 No discharge this period' Out L 4v i, ,.No Sa�m -ota:S H pNew 1G ise'TPH'oEPX-.-` Motor AzI Llsage,,, Solids' Wet o nnua ayprag.e..ga . Wi" thin A Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? - yes _no (if yes, report your analytical results in the table -immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals 9'. 0040 arf.; Qil:artd EPA-Mdih6d-P'::'.--' '"'G �/ '" ,-T.PK Total Sus enP06 hit". g P 'ermi A=t :" ::... ..:-: 15 :` :.: :... . 50 or'10d seepermit For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a ched(mark here. SWU-25r—, Ir tvised"� x 25, 2012 Paize 1 of 2 1 STORM EVt;: i' CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier2, or Tier 3 responses. See General Permit text. FOR PART AAND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART If SECTION B. e 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 ANYONE 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 end of monitoring period in the case of "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 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 gath in the information, the Information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are stnlficapt pegpalti s f subfnitting false information, including the possibility of fines and imprisonment for knowing violations." . (SIgnat ifre of a �r (Date) Additional copies of this form maybe downloaded at: htto://partal.ncdenr.org/web/wq/ws/suZnpdessw#tab-4 SWU-250 last revised October 25. 2012 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted CERTIFICATE OF COVERAGE NO. NCG08 0 / ? 8 FACILITY NAME - L1514 TRUCk NIX, 1,1c COUNTY ,,j RECEIVFF) PERSON COLLECTING SAMPLES LABORATORY Lab Cert. # nFr Comments on sample collection or analysis: CENI rIj.,.__RAL FILE,`- SECTION 9 2018 Part A,. Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR -A) 0 / 9 SAMPLE PERIOD [] Ian -June F] July -Dec . or MMonthly"_ _)U&i1Z_. (Month) DISCHARGING TO CLASS [:]ORW DHQW OTrout OPNA [:]Zero -flow [-]Watersupply ENA [:]Other PLEASE REMEMBER TO SIGN ON THE REVERSE --> r'�71 No discharge this'period' !-P053 -j- J NO -5, `,,S`jiI`CII d art 'p e.; -a ettb s �,!4�pen p N p 9� �..';,'Q q �..a:qq 9 r, 0 TPH'.;E, �A' New qtot,.. 0 E! gel. ... t.- Sali ar u tMethod EM nnua ,a ni m "SpP." Wj�t im'6io Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? - yes —no (if yes, report your analytical results in the table -immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals 5.5 -00 4 EPA- Method: HE Lt 4664:,i(SGT f Tata! Sus ended Solids ... ........... .7i - ..%;- " " "' "Hi p S, .... 6�4�u and -er 'or. tseeLper MI 7 For sampling periods with no discharge.at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-25r—, Ir -wised .,r 25, 2012 Pave 1 of 2 STORM EVE;: i' CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier Z 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. Y 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART li SECTION B. O TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES' ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one cogy of thisMR, including all "No Dischar e" reports within 30 days o receipt a the results or at end o monitoringperiod in the case of "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 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 nformation, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. 1 am aware that there are signifAant penalt r subnjtting false information, including the possibility of fines and imprisonment for knowing violations.", J ` j-2 G (Signa of Permittee (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wglwslsu/npdessw#tab-4 SWU-250 last revised October 25.20I2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted (-o CERTIFICATE OF COVERAGE NO. NCG08Q �( Q SAMPLE COLLECTION YEAR O �� FACILITY NAME i - K tv INC. SAMPLE PERIOD ❑ Jan -June ❑ July -Dec COUNTY RECEIVrn or tA monthly'_ ___ PR)L (month) PERSON COLLECTING SAMPLES •� DISC GING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA LABORATORY Lab Cert. # JUN 2 0 2018 ❑Zero -flow ❑Water Supply ❑SA Comments on sample collection or analysis: CENTRAL FILES ❑Other Part A: Vehicle Maintenance Areas Monitoring Requirements DWR SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE 4 E&No discharge this period' Out#all ,No :........ .... ............,.p.. ,; Date , Sam ieCollec[ed _.,.. ma/dd/yr t.: '{` OD5d 004a0 ''• j00556 _ . TotalSus "ended =: p• . Salids,.mg/L '...#andard;units H, . �..., Non Po ar Oil and Grease/TP,hi E!?A ;r Method 1664(5G� HEM}, mg/L _,. e, New Motor Ozl'Usag .,.,,. Annual?average'gal/mo i Berichmarka a „ - k , 5Q or,1UU 5eespermit ti ; Wlthin 6 `0 ,.9 0... ` ::,15 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? yes _no (if yes, report your analytical results in the table -immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals :Outfal!-.r� • . No :,. ;= Date "-:Sam le Collected :.. Imo`/.d %Yr 00556 :00530 OQ400 Non-Polar:0il and Grease TPFI EPA,Metiiod' 4 •f...:.:, ... :; 1664.(5GT HEM)„rrig[L Total Sus"endedi'Soiids' p �glL :. H P , Standard units Permit,Lii'i'Eit or10Q. see;permit-:, k For sampling periods with no discharge, at any single outfa11, you must still submit this discharge monitoring report with a checkmark Mere. SWU-25r Ir -wised""—) r 25, 2012 Paee 1 of 2 i STORM EVE,: 'CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches); Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: If you report a sample value in excess of the benchmark, you must implement Tler .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 If SECTION B. + 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. + TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ' ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an oriainal.and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the'lab results for at end of monitorina period in the case of"No Discharge" reports} to: Division of Waier 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 da ent and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified per onnel properly gather�and ev luate t e information. submitted. Based on my Inquiry of the person or persons who manage the system, or those persons directly respons' le for ga,t rin informati , the nformation submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are signl1 ant pen ies or mitting fa a in rmation, including the possibility of fines and imprisonment for knowing violations.". (Signs ure of Permittee) (Date) Additional copies of this form may be downloaded at: http:llportal.ncdenr.org(web/wct/ws/su/npdessw#tab-4 SWU-250 last revised October 25.2012 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water QualityU Permit No,NCG080000 CERTIFICATE OF COVERAGE No. N PERSON COLLECTING SAMPLES -----' '---' LABORA70RY Lab Cert,# -- Comments on sample collection or analysis: Part A:Vehicle Maintenance Areas Monitoring Requirements �� --~~��to . [:]zero -flow E]Water Supply [:]SA CEN DWR SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE —> ~�� No this po'ww Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? - yes __no (1f yes, report your analytical results in the table immediately below) PartB: Oil/water Separators and Secondary Containment Areas otPetroleum Bulk Stations and Terminals } For sampling periods with no discharge.at any single outfall, you must still submit this discharge monitoring report with a checkmark here. ` S � ' ' Ir -tvised 25'2012 Puoe I of2 STORM Evi_„� . CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches); _ Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): 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 11 SECTION B. 0 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART li SECTION B. 0 TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YESTI NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copes this DMR, including -all "No Discharge" repo_rts__, within 30 days_of recent the lah results for at end of monitoring period in the case of "No Discharge" reports} to: Division of Water Quality Attn: DWQ Central_ Flies 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 thls�docur ent and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified 'ersonnel properly gath r and a aluate the information submitted. Based an my inquiry of the person or persons who manage the system, or those persons directly rasp sable for It en"Orubmitting i forma on, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are si �icant pgralties Ise information, including the possibility of fines and imprisonment for knowing violations." (Sighpiure of Permittee) (Date) Additional copies of this form may be downloaded at: http:lZportal.ncdenr.org//web/wt1/ws/su/npdessw#tab-4 Swv-25a last revised October 25. 2012 Semi -'annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG080000 Date submitted CERTIFICATE OF COVERAGE No. NCGOS U U SAMPLE COLLECTION YEAR FACILITYNAME LISK- T _] Ian 9ILL k/ N G , L N SAMPLE PERIOD -June ❑ July -Dec COUNTY PERSON COLLECTING SAMPLES, 12�( CI 1141,JF,1,L LABORATORY 140lAl 6-1-C11 j_ Lab Cert. # 573qr2 Comments on sample collection or analysis: Part A., Vehicle Maintenance Areas Monitoring Requirements RECF1VLU - or AMonthly , (month) DISCHARGING TO CLASS E]ORW E]HQW E]Trout E]PNA MAR 0 92018 DZero-flow Elwatersupply 0S .4 cctKOther QVVrN SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE E] No discharge this period' b"ffuu 0 z, :?:No. ::.: ...::... . ;yam Ee..Gollected Tota6Sus ended.:- :. H :Non Palar,0il:and Grease TPH EPA;. sag WIVlotor'01'M Solids•Standard units !:Annuale0 ASG.� al Mm" ml Within . . ..... 75 .2 Lo 71 IA. 5T 0 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? - yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals C 114 Y L.F.0 m; P 6 at; 0 i KEPA!Mdt d""; 0 WT., HIM -Tof d" 'Id' 6 `S6 i 41 p H -units: r::7 ori bt 0 see`permit' V 90 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-25r—,% Ir -wised' .r 25, 2012 Paae 1 of 2 STORM EVk,': CHARACTERISTICS: Date o? /7 (first event sampled) r �I Total Event Precipitation (inches): _ Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): 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 11 SECTION B. • 2 £XCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCI_EDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES N NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES 2 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 end of monitoring period in the case of "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 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 si&-gficant per' sy�ar submitting false information, including the possibility of fines and imprisonment for knowing violations." Pe j&lle (Date) Additional copies of this form may be downloaded at: htt:[/aortaLncdenr.org/web/wa/ws/s_u/npdessw#tab-4 S WU-250 last revised October 25.2012 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG080000 Date submitted U& 4 0, CERTIFICATE OF COVERAGE No. N0008 FACI LITY NAME —)LI 5 K- 1kil f.kIlY G N C. - COUNTY &SON PERSON COLLECTING SAMPLES _PA-7WIZ111) RJ1AJEjLL LABORATORY Or, - A, U &L-ivCAL LabCert.# --,f5q,,7 Comments on sample collection or analysis: Part A.- Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR r,7?6 /tf SAMPLE PERIODE] Jan -June F] July -Dec ! I or°Z monthly" CA6.6. (month) DISCHARGING TO CLASS [-]ORW DHCtW OTrout E]PNA E]Zero-flow []WaterSupply []S"A KOther PLEASE REMEMBER TO SIGN ON THE REVERSE 4 E No discharge this period' 60556". P P I 'G F17 New otorO Solids' l�* S' ar&unift! tand M 004: Sr ;T_ nnua. r "'A Annual ' lz -age �ga �Mq .6i 6 .10 se per.ml L A Jr - Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? - yes _no (if yes, report your analytical results in the table immediately below) Part 8: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals 0 5 Na Sam' . . . . ........ e d� nPo ar.01 'd ",jTPKE0A Method o1a46sk6-So" 'dS HP :.Standard 'Mg/r. 669,;(ST,41EM)M -7. i 15 or .01 ror sampling periods with no discharge, at any single outfa 11, you must still submit this discharge monitoring report with a checkmark here. SWU-25(" Ir :vised"' r 25, 2012 Paize 1 of 2 STORM EWk V i' CHARACTERISTICS: Date 217l , B (first event sampled) f/ Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: If you report a sample value in excess of the benchmarlc, 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 I REQUIREMENTS. SEE PERMIT PART If SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 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 jZNO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one cony of this DMR, including all "No Discharge" reports, within 30 days -of receipt of the'lab results for at end of monitoring Period in the case of "No Dlschara e" 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 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 si0ficant p"K-ss Aor submitting false information, including the possibility of fines and imprisonment for knowing violations.". of JLJ/ (Date) Additional copies of this form maybe downloaded at: http:Hportal.ncdenr.org/web/wq/ws/su/npdessw##tbb-4 S WU-250 last revised October 25, 2012 ,. L Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted 3 /Q ` CERTIFICATE OF COVERAGE NO. NCG08 O 166 - SAMPLE COLLECTION YEAR FACILITY NA E 1_li9K f?ZyCk1NC--,. ! N C-_ __ SAMPLE PERIOD ❑ Jan -June ❑Auly-Dec COUNTY 14NSn rJ or 21 Monthly' Flr.1 , (monthl PERSON COLLECTING SAMPLES �� {-g DISCHARGING TO CLASS ❑ORW ❑HQW [:]Trout ❑PNA LABORATORY Lab Cert. # me l.d ❑Zero -flow ❑Water Supply ❑5A Comments on sample collection or analysis: MAR 9 ❑Other CEN FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4 D\NR SECTION Part A: Vehicle Maintenance Areas Monitoring Requirements �No discharge this period' Outfa ll '. ` Date k r::.Q053Ei% 004QQ, ¢00556 No s Sam IeCollected p TotahSus "ended p P H Non=Polar0ii and Grease TPH„EPA / New Motar O�I`lisa a 'i la , s5olids `' St ` GT HEM}_ Aal.aeragegal/mod166nu randarcunits mg% : ±Benchmark # 50 or_10U see permit .:Within 6 0 . 9:0 :_15 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? - yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals O.utfall= ,.No _ pate' Sam le £ol[ected, r; Imo%dd%yr. "� ? OOS55 4 . _. ,.... . :00530t 00�400 Non Polar 0jl and Grease%TPH•EPA Method _ y 1664(SGi HEM}, mg/L Total=5us'pended Solids, S mgjlt? P H, Standardiunits - Permit�Limit a: 1550�or_100+'§ee:permit . -�- G'.0`-.9.0 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-25( Iwised r 25, 2012 , • Paee 1 of 2 ,-,.!r STORM EVI:,: i' CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: If you report a sample value in excess of the benchmarlc, you must implement Tier 1, Tier z, 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 11 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 (or at end of monitoring period in the case of "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 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 r ponsible for gatherh information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there ar+(s gnifiFant ' g tpe ty far su itting fuse information, including the possibility of fines and imprisonment for knowing violations." re of Perm 3/5-1t8 (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 S"A'U-250 last revised October 25, 2012 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring -Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted CERTIFICATE OF COVERAGE NO. NCGO8 D O 4 cSAMPLE COLLECTION YEAR FACILITY Na� K_jggMrAc, I ry C SAMPLE PERIOD ❑ Jan -June ❑ Auly-Dec COUNTY S�,J. or Monthly' (month} PERSON COLLECTING SAMPLES DISCHARGING TO CLASS ❑ORW ❑HC!W ❑Trout ❑PNA LABORATORY Lab Cert. # ❑Zero -flow ❑Water Supply ❑SA Comments on sample collection or analysis: []other Part A: Vehicle Maintenance Areas Monitoring Requirements PLEASE REMEMBER TO SIGN ON THE REVERSE 4 xNo discharge this period' Outfali = Date ODS30 ":00400 00556: o Sam le:CollecLed TotalSus'ended H _Nod Polar Cl�l`and Grease TPH_EPA` tiNew Motor Oil Usa e' p ,. p, p .,.. mo .dd r' ;Solids rri L .:` Standarii_unjts..:_.:. IVlethod.1664 SGT.HEM ='m .L..:.. AnnuaGavera a a! mo Beichrnark SO or-� 00 see.permrt . .:. > 1N#hin 6 U '. 9 0.. �5 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals Outfalf J0 Date 0556 00530 00400 s No Sam le Cai[ected, Non-Polar.0il a.rid Grease/TP.I EPA.Metho.d', Total Sus` ended_Sol�ds p , p pH, mo dd r ,1664 SGT'HEM)'rn L <m L Standard units Permit.Cimit. 15.: :. SO orDa seepermit For sampling periods with no discharge.at any single outfall, you must still submitthis discharge monitoring report with a checkmark here. SWU-25r 1F -wised .r 25, 2012 Nun 1 of � STORM EVir.: o' CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): _ Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See Genera! Permit text. FOR PART AAND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER ]. REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALLTRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART li 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: Mall an original and one tony of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case o "No Dischar e" re orts) 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 r ponsible for gather' g th information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there ar s gnifi$ant peyditje for su itting fuse information, including the possibility of fines and imprisonment for knowing violations,". re of P 3 t8 (Date) Additional copies of this form may be downloaded at: htttp://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 SWU-250 last revised October 25, 2012 Pase 2 of 2 Semi-annual Stormwater Discharge Monitoring. Report for North Carolina Division of Water Qual'ty General Permit No. NCGO80000 Date submitted 1 CERTIFICATE OF COVERAGE NO. NCG08 (� O j C2 ()361 � SAMPLE COLLECTION YEAR FACILITY NAME ll K hl6 G SAMPLE PERIOD ❑ Jan -June ❑ July -Dec COUNTY �i or Monthiyl �F.f�T_ (month) PERSON COLLECTING SAMPLES c�ZL iDlGING TO CLASS ❑ORW ❑HQW [:]Trout ❑PNA LABORATORY1Tce- AAJ jjLVF AL Lab Cert. # 3 ❑Zero -flow ❑Water Supply ❑SA Comments on sample collection or analysis: RED �p 2 Z011 Other j]~�S PLEASE REMEMBER TO SIGN ON THE REVERSE > SAP 2 5 10 Vf� `` CTIC)pq Part A. Vehicle Maintenance Areas Monitoring RequirementsC]`.I`4TRAL FILES ❑ No discharge this period' UWR SECTION O.utfell " IVo aSaw'm: • Date e,Coilect6d, p;l.. . ....,,, j, ;OD530 ` , r 00400 S 'D055G;' ,, Stand Non Polar:0il`and Grease.. •:.NeiN Vethod 7fi54 SGT HEM)g Matdr Oil ilsa e,/TPHEPA Aomo nruahaerage. of mo , B. mk . -:Tot;al:Sus,pended,: 50 0 permt Withir60encar9 ID 71794/ 0 . S of Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals fO.utfall Y Date k ` ` la 00556 ` 00530 00400 No Sample Collected, Non -Polar Qil and tGrease%TPH`EPA Method Total 5uspended,Solids pH, mo/dd/yr 1664 {SGT�-HEIVI), rr`tg/L' mg/L ` 'Standard units _ - :Permit Limit. ;-. 15 -50 or 100`see-permit`.. For sampling periods with no discharge at any single outfali, you must still submit this discharge monitoring report with a checkmark here. SWU-25C �' 1: -wised `�i r 25, 2012 STORM EVE.:.,'gCHARACTERISTICS: Date (first event sampled) it Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): 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 SAME PARAMETER AT ANYONE OUTFALL? YES Z NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES tKNO ❑ 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 end of monitoring period in the case of "No Discharge" reportsl 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 Bathe he information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are sig fica t pe t' s for s bmitt' g false information, including the possibility of fines and imprisonment for knowing violations." . /. (Sigh ure of Permittee (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 SWU-250 last revised October 25, 2012 Page 2 of 2 w /l5aceAnalytical* www.pecafe MC0rn f ANALYTICAL RESULTS Project: TSS108G Pace Project No.: 92355001 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)8759092 Sample: 1-a $ 2-b Lab ID: 92355001001 Collected: 09/11/17 16:30 Received: 09113117 09:44 Matrix: Water Parameters Results Units Report Limit OF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Analytical Method: EPA 1664B Oil and Grease NO mg1L 5.0 1 09/20/17 05:47 2540D Total Suspended Solids Analytical Method: SM 2540D Total Suspended Solids 94.7 mglL 16.7 1 0911W17 14:29 D6 Oate: 09121 /2017 10:34 AM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 5 of 12 i Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG080000 Date su mitted I SAMPLE COLLECTION YEAR CERTIFICATE OF COVERAGE NO. NCGO8U d C� FACILITY NAME COUNTY L, so t-J PERSON COLLECTING SAMPLES LABORATORY Lab Cert. # Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE PERIOD ❑ Jan -June ❑ July -Dec RE EI t, /V EU or'SMonthly--AUC-USl (month) SAP 2GDISCHARGING TO CLASS ❑ORW ❑HQW []Trout❑PNA It ❑Zero -flow ❑Water Supply ❑SA CENTl-V;L FILES ❑Other PLEASE REMEMBER TO SIGN ON THE REVERSE 3 N/Vo discharge this period' -Outfall- _No .Y Sam r Ie<Collected .:: mo/dd/yr ,=. -t r 00400._.: :D0556 ..: Total Sus ended ;' -: Solids, mg/L r :: H 5taridard units. Non Palar_Oil`:and Grease :TPH EPA:IVev�r.Motor_Oil`lisa :Method'1664 (SGT HEM),'.mg/#. Aririval ai►erage:gal/mo =Benchmark' 50 6r,;10D see.perTriit .:Within Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals Outfall t Na Date v Sample Collected, mo/dd/yr 00556'<,_ OOS30 ;00400.: Non Polar Qil and' Grease%TPH EPA Method �1664 (SGT=HEIVI); mg%L TotaE Suspended Solids, ° = nig/L phl, Standard units ;P,ermit Limit_ ', . - _ :. 15.• 50 or'1D0'see permit 6.0 -.90 j For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-25(r lr •Avised j .r 25, 2012 i STORM EVE.. -.'CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): 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 SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one cony of this DMR including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case of "No Discharge" reivortsl to: T 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 ries nng a information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there areAgnificpnt p n+ for s bmitting false information, including the possibility of fines and imprisonment for knowing violations.". l 9 aI17 (Si na ure of Per (Date) Additional copies of this form may be downloaded at: http:/Iportal.ncdenr.org/web/wq/ws/suZnpdessw#tab-4 SWU-250 last revised October 25, 2012 Page 2 of 2 Semi-annual Stormwater Discharge_ Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG080000 Date submitted CERTIFICATE OF COVERAGE NO. NCG _ (Q - 0,yL/ ! ! j SAMPLE COLLECTION YEAR FACILITY NAM U SRJ + RtjciKf �.�(, r 1 /IIC' SAMPLE PERIOD ❑ Jan -June ❑ July ec COUNTY �01�_ or JX Monthly' month PERSON COLLECTING SAMPLES DISCHARGING TO CLASS ❑ORW [:]HQ ❑Trout ❑PNA LABORATORY Lab Cert. # ❑Zero -flow ❑Water Supply [:]SA Comments on sample collection or analysis: ❑Other S EP 2 5 2017 PLEASE REMEMBER TO SIGN ON THE REVERSE 4 <AL FILES Part A: Vehicle Maintenance Areas Monitoring Requirements DVv`' SLEL T ION No discharge this period' Outfall Date r00530;' . OU400 =00556 No Sample Collected, ;Total Suspetdedx „;.: pH, Nan Polar Oil and Grease/7P_H4EPA New Motor. Ci�I iJsage, mo .d`d r. . Sohids ;m ' L '. . Standard_uiiits Method'1664 SGT"HEM ni' L .Annual a�era a 'al mo Benchmark`' 50.or see - permit Withm6 0 ?9 0 15 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes `no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulls Stations and Terminals Date Clutfall :0,0556`,. Od530 >00400 No Sample Collected, `Non Polar Oil and'Grease/TPH EPSoll A Method Total Suspended ds,` P.. mo/dd/yr: w. ,1664,.(SGT=HEM),;rr�g/L .. e >. :' :mg/L Standardunits.. Permit Limit, 15 50 or10U'see permii 6.0.. 9 0., 3 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-25r� �} I, -Avised ) r 25, 2012 STORM EVhl." k' CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: if you report a sample value in excess of the benchmarlc, you must implement Tier 1, Tier 2, or Tier 3 responses. See Genera! Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART ll SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES POR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an on inal and one copy of this DMR including all "No Discharge" reports, within 30 da s of receipt of the lab results or at end of monitoring eriod in the case of "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 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-ttNe information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are sj4nificpnt pe�al�es�or sgbmittin,7false information, including the possibility of fines and imprisonment for knowing violations." "re of Permittee) d 7 (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-A SWIJ-250 last revised October 25, 2012 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted CERTIFICATE OF COVERAGE NO. NCG08 0 d 0 FACILITY NAME L-15V, IQ-UCK IN G' I COUNTY A 1U So N _ PERSON COLLECTING SAMPLES LABORATORY Lab Cert. 4 Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR SAMPLE PERIOD ❑ Jan -June ❑ Jul -Dec s i1 � - or XMonthly'L �Cin1�— (month) DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA SEP 2 5 2017 ❑Zero -flow ❑Water Supply []SA ❑Other CE,"q T F,AL FILES Ctvl� SE0Tl0N PLEASE REMEMBER TO SIGN ON THE REVERSE 4 RNo discharge this period1 Outfail ' t No Date Sam !e Collected, P 00530 .. 00400 ` `00556 ,Total Suspei7ded _ mg%L } P H, :Standard units Non Polar_OiI and Grease/TP.H EPA _ Metliod`1664,(SGT.HEM), rig/L New Motar OilUsa e, g Annual average,gal/rno Benchmark'. „ , ;:.'. 50 0r.:'100 see,permit° With! 0,-. 9 0 15 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals Qutf''I No . Date' ��z, Sample Collected, ,mo/dd/yr .. ... �'?..._., 00556_: :00530 00400 , : Non Polar Oil and Grease%TPH EPA Method r , " . `. 1664.(SGT HEM},;mg/L Totai Suspended Solids, > 4 -=nig/L� ApH, .:-5tantlard;units, Permit Limit _ 15 . -50 or'100see Hermit . 6.0 9 0 .:. For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-25( I •Avised \j •r 25, 2012 D...+� i STORM EVE.:..' CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (incites): 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 11 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 ANYONE 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,__includ�in g all "No Discharge" reports, within 30 dogs of receipt of the tab results (or at end of monitoring period in the case of "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 attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel proppAMather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for garies ring he information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there arej$igniflian en 4 fo submrtting false information, including the possibility of fines and imprisonment for knowing violations." ature of P ?/af (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wg/ws/sulnpdessw##tab-4 SWU-250 last revised October 25, 2012 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted CERTIFICATE OF COVERAGE NO. NCG08 ( 0_0 0 0 )v C C,- e) FACILITY NAME L15K —nZu 1/_1NG ij C - COU NTY j PERSON COLLECTING SAMPLES LABORATORY Lab Cert. # Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements 10 /,AMPLE COLLECTION YEAR SAMPLE PERIOD _QJan-June 0 July-D c U or N Monthly' Vk[7 (month) DISCHARGING TO CLASS F]ORW []AQW F]Trout OPNA Zero -flow owatersupply 0S .14 Other RECeiver JUN 12 2017 CENTRAL FILFP� r"j. - PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Z No discharge this period' 00 6' a:IV"d" 0 I illilfti§a, 4. -S P 1 T* Q 9'7 P P r; 0 1 �New:Motor' I sage dd/ 'S I"d4' ' m9i -,--rStah Standard It Mkhbd1664�(SGT�H nnuaravprage:gq Benchmark :. C Wit nli Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes —no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals bbtfa ""A Sam dd5 '0 0 ll�.afi'dhod. 1664:jSGT�,H M) E L ��Sy4oen' e f" 'k _.. . ,,, . ..:. an dii&�6n its " ermit or.10 1edapefini For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-25(` 1;7 -wised' r 25, 2012 Paize 1 of 2 STORM EVt;: 'CHARACTERISTICS: Date . (first event sampled) Total Event Precipitation (inches): _ Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note. If you report a sample value in excess of the benchmarlc,-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 SAME PARAMETER AT ANYONE 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 OMR including all "No Discharge" reports, within 30 days of receipt of the lab results !or at end of monitoring period in the case of "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 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(alti h ring the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there agq slgNficat-A p for submitting false information, including the possibility of fines and imprisonment for knowing violations." of Perm 5 17 (Date) Additional copies of this form may be downloaded at: http:/Iportal.ncdenr.org/we_b/wq/ws/su/`npdessw#tab-4 SWU-250 last revised October 25, 2012 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG080000 Date submitted &/-dGI7 CERTIFICATE OF COVERAGE No. NCG04 0 _Q,QL FACILITY NAPOE —1 COUNTY -AN-5j)Nj PERSON COLLECTING SAMPLES LABORATORY Lab Cert. # Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR SAMPLE PERIOD F]Jan-June F]July-Dec or foMonthly; MIL- (month) DISCHARGING TO CLASS []ORW F]HQW []Trout DPNA E]Zero-flow []Watersupply DSA ;gOther PLEASE REMEMBER TO SIGN ON THE REVERSE -> X No discharge this period' S Od 40 0556 q �.Susp dh 0 'dsAnnual! , 4. P H , Standard n 6rd:u"nt s� -;Non"-Pd w, d1004, $GTNEM ):�Aj/ ..::Method Usage, 1V LW#ge. za ma -; tenBenchmark: 0 seer per I . thm'6&: Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no (if yes, report your analytical results in the table immediately below) Part B- Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals 4 11CLMdi" Vu AonPolar Oiand PWEPA,Meth6d L Z Total'Sus'o en`d"2 "So ds, :Standard units,�'.1.-.:... P 5 it :or: -perm see For sampling periods with no discharge,at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-25(" IF, -tvised"' .r 25, 2012 Paize 1 of 2 STORM EVt;: i' CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): 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 RAND PART S 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 on final and one cogy of this DMR including ail "No Dischar e" re orts within 30 days of receipt of the lab results forat end of rnonitorinaperiodin the case o "No Discharge," reports) to: _ Division of Water Quality Attn: DWQ Central Files .t 1617 Mail Service Center-• Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: N 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 g ring the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there arA significantRenblti4 for submitting false information, including the possibility of fines and imprisonment for knowing violations." re of Pe . y Z/ z (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/ni2dessw#tab-4 SWU-250 last revised October 25, 2012 Page 2 of 2 Semi-annual _Stormwater_Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG080000 Date submitted _ CERTIFICATE OF COVERAGE No. NCGO8 o O O 6 8� 1 SAMPLE COLLECTION YEAR 2617 FACILITY NA E LZ 5K -TjZU IN G IN C . COUNTY I- 60�j PERSON COLLECTING SAMPLES LABORATORY Lab Cert. # Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE PERIOD ❑ Jan -June ❑ July -Dec or 1Z Monthly' 111,4904 (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA RECEIVE[) []Zero -flow ❑Water Supply ❑SA Other APR 12 ?� i CENTRAL F!I~ES PLEASE REMEMBER TO SIGN ON THE REVERSE 4 DWG SECTION �z No discharge this period' Outfall Doi a 00530 ._ ;Q4400 :No Sam ie Co#lected Total:Sus ended H, No.n-Polar'O�I and"Grease/TPH `EPA Neiti Motor Oil Usa e p p p. g mo dd r ±B Sdsr, 6unt. GTHMnAftnUal edadolrig/LStanV sepermtencfWlthm' n Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals Date g 40556 00530 0040fl No Sample Collected, Non Polar Di) and GreaeJTPH EPA Method Total Suspended Solids, pH, mo/dd/yr 1664 (SGT liENl), rrig/L :mg/L Standard units Permit Ltrriit`, 15 50 or 10D seerperm�t "6.0'.- 1 For sampling periods with no discharge.at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-25f`n, Yl' I, -wised" 1 r 25, 2012 • 17ar.a Z of 7 STORM EVt,. i' CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): 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: s A BENCHMARK EXCEEDANCE TRfGGERS 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 lE SECTION B. TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME: PARAMETER AT ANYONE OUTFALL? YES 0 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 end of monitoring period in the case of "No Discha e" 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 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 ark signifycarApen Iti s for submitting false information, including the possibility of fines and imprisonment for knowing violations." . of 0-'7 (Date) Additional copies of this form may be downloaded at: http,://portal.ncdenr.org/web/wa/ws/su/npdessw#tab-4 SWU-250 last revised October 25, 2012 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG080000 Date submitted CERTIFICATE OF COVERAGE No. NCG08 6 0 cc) FACILITY NAME L-1 5 K Tpu C<j N C i N C- COUNTY AAt:-qdrj PERSON COLLECTING SAMPLES 031-TdI S K LABORATORY PgtF- &tq�LncAL - Lab Cert. # S-341.d' Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR o / 7 SAMPLE PERIOD [] Jan -June ❑ July -Dec . or 19 Monthly" (month) DISCHARGING TO CLASS [:]ORW E]HCtW /'OTrout E:]PNA VE[]Zero-flow OWater Supply 0S .4 RECEID Other MAR 07 Z017 DQ CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4 DVVR SECTION [] No discharge this period' --buff 3 00556 '! .... .. P Non -Polar..... !Wag 1. 'Annual Solids. �mg /L :Standard unk, arie iBdrit -mar ee'V.ermft1 im TD Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? - yes _no (if yes, report your analytical results in the table immediately below) -- .-, t Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals t No . Pi �:,Greasb TPKEP&Met o Total -Suspended "J Stan �; d units ' — Yr ar Permit Limit -see-per mi For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. �r25, 2012 SWU-25(' Ir- -wised Page I of 2 STORM EVE;:,' CHARACTERISTICS: i Date 1 iS I (first event sampled) Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): 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 AAND PART 8 MONITORING RESULTS:- • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART If SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART if 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? i •YES ONO ❑ REGIONAL OFFICE CONTACT NAME: N E-C FZ di Mail an original and one copy of this DMR, including all "No Discharge" rev_ orts, within 30 days of receipt of the lab results for at end of monitoring period in the case a "No Dischar e" re orts to. Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOUWUST 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 ath n the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are Anificant enalti. s f r submitting false information, including the possibility of fines and imprisonment for knowing violations." A� YI-2 Z, are of Perm ee) (Date) tt Additional copies of this form may be downloaded at: http://Rortal.ncdenr.org/web/wg/.ws/su/npdessw#tab-4 SWU-250 last revised October 25, 2012 Page 2 of 2 '=~Semi-annual Stormwater Discharge Monitoring Report o Date submitted CERTIFICATE OFCOVERAGE No. NCGO8/ 0 d /l FACILITY NAME COUNTY PERSON COLLECTING SAMPLES - --- LABORATORY Lab Cert. # partA: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR jo(7 SAMPLE PERIOD JanrJune July -Dec or Monthly' JAN. (month) DISCHARGING TO CLASS EJORW [:]HQW [:]Trout DPNA IgOther ��U��U��U�� K�K��K�U�K�� PLEASE REMEMBER TO SIGN ONTHE REVERSE 4 - FEB�7 �0�7 . ^- -- � �No discharge this period'�. MR -SECTION On Did thisfacility perform Vehicle Maintenance Activities using morethan 55 gallons of new motor oil per month?_yes __no (if yes, report your analytical results inthe table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals utf Uot / For sampling periods with no discharge.at any single outfall, you must still submit this discharge monitoring report with acheckmarkhere. ,._�/_-\ S\�TJ'25/\ ' l, -wised—) r25,2012 r STORM EVIL -,.-'.'CHARACTERISTICS: i Date (first event sampled) Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): 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 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 ANYONE 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 Discharae" re orb ts, ithin 30 days of receipt of the lab results (or at end of monitoring period in the case of "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 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 sign ifjcant p4�naltAftor subrpitting false information, including the possibility of fines and imprisonment for knowing violations." ature of Perm ` _I (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wg/ws/su/niodessw#tab-4 -� SWU-250 last revised October 25, 2012 Page 2 of 2 Stormwater Discharge Outfall (SDO) Monitoring Report Facsimile Permit Number NCS000105 Facility Name: Blue Ridge Paper Products Inc. dba Evergreen Packaging Person Collecting Sample(s): Nick McCracken / Tracy Willis Certified Laboratory(s): Blue Ridge Paper Products Inc. dba Evergreen Packaging Laboratory Certificate: 4198 Part A; Specific Monitonm ReQuirements Samples Collected During Calendar Year: 2017 County: Haywood Phone No.: 4 (Signature of Permittee or Designee) By this signature, 1 certify that this report is accurate complete to the best of my knowledge. Outfall No. Description Date Sample Collected 00400 00530 00310 H Total Suspended Solids BOD-5 mo/ddl r Std. Units mgfl m I WTP 1/23/2017 6A 58 2 Mingus Branch* 1/23/2017 6.5 172 3 Mingus Branch* 1/23/2017 6.8 279 2.07 4 WTP 1/23/2017 6.4 76 5 WTP 1/23/2017 6.8 388 6 Camp Branch* 1/23/2017 7.2 30 7 Camp Branch* 1/23/2017 7.8 49 8 Canton Mill 1/23/2017 7.5 32 9 Canton Mill 1/23/2017 7.5 8 Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Al** _no Storm Event Characteristics: Date- January 23, 2017 Total Event Precipitation (inches): 3.11 " Event Duration: 39 hrs Mail original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh. NC 27699-1617 '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.' ;nature of Permittee) Stephen Hutchins - Outfalls 2 ! 3 and 6 17 are connected. Outfalls 2 and 6 enter the facility from otfske and discharge from Outfalls 3 and 7. "- Vehicle maintenance area stormwaW discharges to mID sewer system and to the WTP. Ir3)f�7 (Date) r 4 RECEIVED JUL 21 Z014 �� CED Q BOGES Storamwater Discharge Outfall (00) Qualitative Monitoring Report For guidance on -filling out thisform,please visit hUp:J%portal.ncdenr.orglweh/wq w�f uu/JrWes!,w#-tab-4 Permit No.: �V /�/ a/ 8/� / o /� / �/ d / or Certificate of Coverage No.: Facility Name: L15k 7RuCK1tiG 1NC� County: N ujr j Phone No. 7-dY- 27a G/o1- - Inspector: _ „ - g _ Ida r jg 4 z- Date of Inspection: - —5 - _/,s =1 Time of Inspection: Total Event Precipitation (inches): _3 7S` inr._ Was this a "Representative Storm Event° or "Measureable Storm Event" as defined by the permit? (See information below.) �es ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event' or "Measureable storm event" (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable, A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no i precipitation. A "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter interval is representative for local storm events during the sampling period, and the permittee i obtains approval from the local DWQ Regional Office. i By this signature, I certi�that this report is accurate and complete to the best of my knowledge: (Signature of Permittee SW11-747 1 act mn•HR.A i A ME nn, � Pagel of 2 STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT GENERAL PERMIT NO. NCG080000 SAMPLES COLLECTED DURING CALENDAR YEAR; _26 iLi CERTIFICATE OF COVERAGE NO. NCG08 019 b (This monitoring report is due at -the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) FACILITY NAME L I SK �tuCKINc, JAJ C • COUNTY ' 6N5u,-j PERSON COLLECTING SAMPLES .1_ R . _ Pd I ,49LI- _- _ PHONE NO. (mayy) A 7,2 - 41 a I CERIITMD LABORATORY _ /�R_ GE V41-yri eR_ 1— - _ Lab # TJ 9 Lab # PLEASE SIGN ON THE REVERSE 4 Part A: Vehicle Maintenance Areas Monitoring Requirements Did this facility perform Vehicle Maintenance Activities using more than 51 gallons of new motor oil per month? yyes no (if yes, report your analytical results in the table immediately below) ' < :,1 ```` �^ r ■vim■ .i -Y,40 vSwi:.�,.::l.: � ��e .. S\.:`.rr.l f � .. -tr Y'1 ,^1•:., r'"! \,Ci f'„ 8 r'ai' f I� 1�'L. - '•1 f r , J i'q.41 :, 4ia�t1 1 ` ollect . •.; ��_{yl�'. �(�� c.f S r.><1[RO f Uu ! .b71 :.-• �fi'�`�I•t .••4rf •': fir.. ,vJr�r�i.' A. 1�?` I ....ul ' _' a' w 4 F..l[= y �.. , 3. {..' f r1-� •� i l f, , ; Ui fund ",ease, i �y, 7�� `l.� 10 +. '!•.'',�', Ne otor TJsag, ,y ai, 7 r 6r .'',t, + I .l �.�. r . F', ki,, .tl _. t e•; �� '}fh}?�• rr.:, •_ rC�`l r . «„•:R�' f I'.r t�j•t t'!7L,:r' r. ..rYri r�. ;;m0/L�`1 r! k„R"9,.r !�.. ��r7 kan ��t:��U►��,;;?*�1 � _.�:,�4.r�:t1 ��w; . !F"' a lE'� :ls n r yr: �:z'= - � J.run.' 1t00 . i _.AVitlih►,.b�0:.. isa� ..M. ( r it r'r - Q:b" �, '•Ix . 2•. :r -- rr r6I 3,b. bi .s. ;.. �ra;.:.;':xt::.<�;Ir-"t,r•;� I h;q .;.,. 7.3 /VQ Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. Part B: Off/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals '1 ':7'. �' tJutfall4t �'! �_;�•J'. y a 1- $}1Y�"r,prpaLet 5�1�:a' ;! - • t'Yl2° r^- �"i" ^� ��k rK a00J�SVa:•n. -n r r :, '4 �j"r•' .kh ref ¢ vy Ri�lr„J� �d�� '},12?t�.a d'r✓FtV��7J.Qh�c111 trR�r '{�'� �1 A I- f r- ..004�y - i_ l,r r K�-�r r.r I� grNa, i'� r 8ariklr; Collected, �, w: " ;�,r5"Oil agd.Grease, r,,�°;t�Total;Suse�(� Solids, �a`x 4 •-il 4. a r f pHt4t� 4f i FI 'i i -r r �irytr,. C � c5 I� .•4.i-'?"i.`t .S rl i.5.. •. J'+'-J'.wt�. 4�?� >..:�. 4r, F.`C '/-y �t1�.11 .�_ �i. _ y�. 3 `�s` {� t' I,!' Lr1i.1. ?T;�.r r', `'': .-,,t mo/dd/ .;f..rff ;� �:4%.T�rr ,..7.:�� t', I+i.: �i 41.'StanYE8rd:.µQit�'I .y..4V L k ui Tt M Y Peridit`L'iuiii4�'t�rk o:., STORM EVENT CHARACTERISTICS: Date 11 (first event sampled) Total ltvLfnt Precipitation (inches): 3.751N" Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Mail Original and one copy to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 SWU-250-102107 pan.. 1 r.f'f Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG080000 Date submitted CERTIFICATE OF COVERAGE No. NCGO8 0 0 0 0 /V < f 6: - Fs) SAMPLE COLLECTION YEAR FACILITY NAME L16K jjWCj<jN0, IN!I-. COUNTY A rq no ti - PERSON COLLECTING SAMPLES LABORATORY Lab Cert. # Comments on sample collection or analysis: Part A- Vehicle Maintenance Areas Monitoring Requirements SAMPLE PERIOD E]Jan-june O.Iuly-Dec or aMo-nthlyl DE-C. (Month) DISCHARGING TO CLASS []ORW EjHQW E]Trout E]PNA []Zero -flow Owatersupply EISA RECEIVED Other JAN 18 2011 PLEASE REMEMBER TO SIGN ON THE REVERSE --> CENTRAL FILES IgNo discharge this period' DWR SECTION 3 5 J. Od pH,, Non Polar 0i! d" 4e/,T-0 Soil srh d u s,:-1.,;,.,: : - Method 16V mot 1; 9 e A n erage. n V� 0 r.', :S -1: 7 enc mar qq,pgrmj..,: Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yes —no (if yes, report your analytical results in the table immediately below) Part 8- Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals OutfaiiDateF 4 v .5 t 6 005 30. ar-Oi-6rd-... PH ,EPA,Meth 'd. T:` Totausoeid" S pft A66 THEM) L' junits! Standa ? r& 7 rm t LI mit or'! See,Permi 0 For sampling periods with 'no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-25(-' 4- -wised---) r25, 2012 { STORM EVE„.' CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): 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 11 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 end of monitoring period in the case of "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 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 gathe ' g t e information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there arelsigniflant peniti s for bmittir)g false information, including the possibility of fines and imprisonment for knowing violations." ature-of Permittee) (Date) Additional copies of this form may be downloaded at: htto:Z/portai.ncdenr,org/web/wa/ws/su/npdessw##tab-4 SWU-250 last revised October 25, 2012 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted 11;2- 6 -12ol10 CERTIFICATE OF COVERAGE NO. NCG08 U [� „Q O �`�, MPLE COLLECTION YEAR p7 4 FACILITY NAME Li 54< N SAMPLE PERIOD ❑ Jan -June ❑ July -Dec COUNTY A 1��U r�l � or � Monthly' ��>L (month) PERSON COLLECTING SAMPLES DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PM1IA LABORATORY Lab Cert. # ❑Zero -flow ❑Water Supply �5A Comments on sample collection or analysis:EIED Other RECV DEC U 9 ?AI%SE REMEMBER TO SIGN ON THE REVERSE 4 Part A: Vehicle Maintenance Areas Monitoring Requirements CENTRAL FILES No discharge this period' OWR SECTION Outfall Date 00530 00400` 0055617 , E t f '�:Na ::5am' Ie Collected TotalSus ended ;� H r Non -Polar Oil and Grease TPH EPA' s NewMo#or=Oil usa e .., ..• mo.dd/yr rti Me#hod T664 (SGT H_EM), mg/L Annua! average < ::::: ..:.....::Solids�,mg/i... °::-Standardts : gal/mo +Bentih"mark �:Wrthm60 15 °'';, :50:,or100seepermd.;: :9:0. ,. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals Outfafl x v Date t , c5 o053Q�' p040D `IVo Sa`m le Coflectetl, p Non Polar,Orlanci Grease/TPH'EPA Methotl Total Sus entled Soiitls p 'H p_, L.. LY rn:; _ 1654 SG7 HEM L'': (. �, j` ';', Lh .tld' ,, ,. m g/ �:.m gI :Stanclard;units` Permit Limit'._i - .r ;.. F :.., ;,; 15 50:or,.100`see-permrt For sampling periods with no discharge,at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-25(' 1�--wised"'—) r 25.2012 STORM EVII:�.,' CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): _ Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): 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 &MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 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 ANYONE 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 end of monitoring period in the case o "No Dischar e" re arts 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: "1 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 gat" the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are/pigni4nt penal ies fqr submitting false information, including the possibility of fines and imprisonment for knowing violations." ure of Permittee) �/z, A, (Date) Additional copies of this form may be downloaded at: http://portal,ncdenr.org/web/wq/wss-u/npdessw#tab-4 SWU-250 last revised October 25, 2012 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG080000 Date submitted 10 / I .? I/ � ly a I I? -P CERTIFICATE OF COVERAGE No. NCG08 () 0 0 0 FACILITY NAmk Ll �i[ T-4Z.U(KiNG —A C - cduN" 14 IV so 1,j PERSON COLLEgING SAMPLES cLj F— LABORATORY 1j'9CP-- AvA.V.TiCAL- Lab Cert. # Comments on sample collection or analysis: Part A; Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR 20)(4 SAMPLE PERIOD M Jan -June E]July-Dec or %-Monthly'. SEp-r, (month) DISCHARGING TO CLASS 0ORW E]HQW [:]Trout OPNA RECEIVED []Zero -flow []WaterSupply []SA OCT 17 mls NOther CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4 DVVR SECTION El No discharge this period' 005 3 t �5, % 7; 1,� 0 55 -Tota :Suspende jT N �-Pblai�:011-,"ii6-d;Griibs-e/.TPH.; Ar ?',146n� ON W,'Mot 'D U ah L 4ih t mg/ avers rnor, gegal Vn 1. `! 910 �6 ? 1 Did thi's facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? yes _no (if yes, report your analytical results in the table immediately below) Part 13: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals 3-'Vokfill 9 st "T -o"Od k, 7 as; 0 !EPAMeth'bd 'N H' :So Na 5am le Collected,. 5- , �� 1;11, " -t -,, 1� i dffid/y . , - 11 1 F� - -- �,, V 5i , WON N 4E S d&& ' Mitli'm" lt� P� i5l;' :01r.-100 s0!&,perrn U,- r --k For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-25, IF -tvised X25,2012 I l STORM EVr i' CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): Date- _ (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: if you report a sample value in excess of the benchmark,'you must implement Tier I, Tier 2, or. Tier 3 responses. See General Permit text. FOR PARTA'AND PART B MONITORING RESULTS: _ A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 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 tA NO ❑ IF YES, HAVE YOU CO NTACT E D'TH E DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail -an oriainal and one coon of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at•end of monitoring period in the case of "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 attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly athe and evaluate the information.submitted. Based on my inquiry of the person or persons who manage the system, or those.persons directly /r� ponsibl'e for gather'' the i ormation, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there �fe�ignifie t penal or sub itting false Information, including the possibility.of fines and imprisonment for knowing violations." gn.ature of Permittee) . �a & (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/Wq/ws/sulnpdessw#tab-4 SWU-250 last revised October 25, 2012 Page 2 of 2 r LISK TRUCKING INC. P.O. BOX 70 POLKTON, NC 28135-0070 Phone (704) 272-7641 WATS 1-800-438-7711 FAX (704) 272-8578 RECEIVED OCT 17 201S CENTRAL FILES DWR SECTION To whom it may concern, In sending this report, We (Lisk Trucking Inc.) understand we are still sampling out of our permit limit .1 am coordinating with the sampling lab (Pace Analyticaf),to further our efforts to finding an answer to the reason our samples have been out of limit. As soon as Pace can give us more information, I will forward it to you. Sincerely, 2 Semi -'annual Stormwater_Discharee Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted_ 9 -1-,20110 l IF CERTIFICATE OF COVERAGE NO. NCGOS U 0-_4e�-'6. FACILITY NAME 5 AjG j nrC COUNTY . N S 6 ►'Q,.,,- PERSON COLLECTING SAMPLES LABORATORY Lab Cert. ## ---'�' Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements RECEIVED SEA 14 2016 CENTRAL FILES DWR SECTION SAMPLE COLLECTION YEAR C7 d I & SAMPLE PERIOD ❑ Jan -June ❑ July -Dec or 9 Monthly' f month DISCHARGING TO CLASS ❑ORW ❑HCJW ❑Trout ❑PNA Zero -flow [:)Watersupply []SA Other PLEASE REMEMBER TO SIGN ON THE REVERSE 4 KNo discharge this period1 Date + 0053Q r' '004Q0 00556 ;;No Sample Collected, 'Total'Suspendad =pH, Non -Polar Cill and Grease/TPH EPA' New Motbr.OII.Usa ., ;_Stand6 d.6hIts, ' L..._; average,gal/,mo. . , . .... Method'1664;[SGT-HEM)►,rn Annual •; Onarr pB Wnithm'6 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _,,, yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals r�OutfaN ` �� ,�4 ' •;Date r }` 00556 00530 00400 Na. E ; Sample:Collected,. Non Polar Oil and Grease/TPH EPA Method >` Total Suspended So1Ids ypH, i4... `«- ,4IrR3•" v lrl: •"Z'v;1.-�..y'w: 5. ..air .,, _ �d a 1.c-1 - .�,.s-J; .; x ,? N L��' C; ,, t HEM}„m$/L .r — 1 - :Y `-":- i mo%dd/.Y= _ ._, ;� .. �_. ,1664 (SGT ,j 1. m L s r c_ g/ Siandard'unit s Pe►mit10U'seepermit 1 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-25r 1: -wised .r 25- 2012 0 STORM EVE.. i• CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): _ Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation -(inches): Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 1, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: o A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. 0 2 EXC£EDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTI N 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 ❑ TTT"'''' REGIONAL OFFICE CONTACT NAME: 1 Mail an on Inal and one My of this DMP, including all "Na Discharge" re artswithin 30 days of recelipt of the lab results Lor at end of monitoring eriod in the case of uNo Discharae" re oorrtsLto: 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 Vkher and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, orthose persons directly res onsibi for in h information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there areAgnific/nt pe alti fof s miffing f4lse information, including the possibility of fines and imprisonment for knowing violations." re of Y! 16 (pate) Additional copies of this form may be downloaded at: http:J/portal.ncdenr.ora/web/wgLws]5u/npdessw#tab-4 SWU-250 last revised October 25, 2012 Page 2 of 2 Semi-annual Stormwater Discharge MonitorinaRReport for North Carolina Division of Water Ouality General Permit No. NCG080000 l� &-0 �Dsubmitted d I(o 1 ►.—Jp 0 SAMPLE COLLECTION YEAR [ �a CERTIFICATE OF COVERAGE NO. NCG08_ _ � FACILITY NAME Li S UC rJG _ IJC ` SAMPLE PERIOD ❑ Jan -June ❑ July -Dec COUNTY 4N 5UN or CKmonthlyl JU N F— (month) PERSON COLLECTING SAMPLES DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA LABORATORY Lab Cert. # Zero -flow ❑Water Supply ❑SA Comments on sample collection or analysis: RL Other JUL 2016 PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Did this facility perform Vehicle Maintenance Activities using more than 55 gallonsCEh��t�i[r er month? _ yes _no PJf (if yes, report your analytical results in the table immediately below) r)�N Part A: Vehicle Maintenance Areas Monitoring Requirements (lf applicable) FO No discharge this period' Outfall �f]ate= ;..00530. _ '..', `' ' : 00400 .: _. 00556, , No amle S p Collected, Total Suspended pH, Non=Polar Oil and Grease/TPFi EPA New Motor OBI Usage, mo/dd/,yr; Solids; mg/L Standard°units Method 1664,(SGT-HEMh mg/L Annual'average gal%mo` 13ertchiiark `$ 50 or'.100 see: permit;, Witfiin.6 0 :.9.0 Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) OutfaN No. Date Sample Collected, :: r. -00556 00530 - 00400 Non-PoI6r:OiI and;Grease/TPH EPA Method,', =total Suspended Solids, X pH `. '' ';. a. 1664.(SGT }�y mg/L .1p _ _ Wun:19 mo%dd%Yr .`. .. _ ; 11EMj; rrig%L ;� :: Stand Permit Limit µ 15 . 50 of 100 see.permit 6.0 "- 9 0, �> I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. S W U-250 last revised April 11, 2013 Page I of 2 STORM EVENT CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): _ Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): 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 SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO 1F YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO [] REGIONAL OFFICE CONTACT NAME: Mail an oriainal and one canv of this OMR, includina all "No Dischorae" reports, within 30 days of receipt of the lab results for at end of monitorina period in s _ the case of "No Discharae" reports) to:. - Division of Water Quality - Attn: DWQ Central Files 1617 Mail Service Center'' Raleigh, North Carolina 27,699-1617 "I certify, under penalty of law, that t 1s docu ent and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personn properly g her an evaluate the information submitted. Based on my inquiry,of the person_or persons who manage the system, or those persons directly res risible r gat a info ation, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are i ifica penaltie rPubmi ing false • ormation, including the possibility of fines and imprisonment for knowing violations." Si ature of Permittee) _ (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/wslsu/npdessw#tab-4 SWU-250 last revised April I I, 2013 1.- .' Page 2 of 2 Semi-annual Stormwater_Dlscharee Monitorin�Report for North Carolina Division of Water Quality General Permit No. NCG080000 Date submitted CERTIFICATE OF COVERAGE NO. NCG08-.O- -.a SAMPLE COLLECTION YEAR �al FACILITY NAMN LI SK T7zLtUI m (S INC • SAMPLE PERIOD ❑ Jan -June ❑ my-D COUNTY SCi 11 e � or Monthly' (.L�- month [� f EE t 1\/i� 91SCHARGING TO CLASS ❑ORW ❑ QW ❑Trout ❑PNA PERSON COLLECTING SAMPLES — Zero -flow ❑Water Supply ❑SA LABORATORY - Lab Cert. # — AUG 0 5 201,- Other Comments on sample collection or analysis: CENT RAL FILES DWR SECTION , PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no /U//g (if yes, report your analytical results in the table immediately below) Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable) �fNo discharge this period' 'Outfall' ,. t No ., .4_mo/dd/.yr; ;Date Sample Collected, �, .wr .00400 :....: ..:' 00556 Total'Sus .. fended Solids, mg/L pH, Standard.units . Non -Polar Oil and�Greas4/T0H EPA Method 1664(SGT`HEM) rng/L' `- New MotorOil Usage, , , , Annual average'gal/rrio Benchmark , _. ,.r , , 50 or;100.se'e permrt- ,Within 6 O,S9:0 Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) Ou1#all `_:`_Date~` 00556 00530 00400 :No.':., Sarn01.i!Y Collected _ Non -Polar Oil and Grease/TPH:EPA Method': Total:Suspended Solids, - pH 4h..'::.L4j7i:-3t5!• dd/yr :: S4.eiS ".a i ,E 4`.a F ,:y V 1664:(SGT.FIM), mg/L #. •h . . .b ing/L . ... Y., •--t Standard unitsr. Permit Limit 7 :., .. ;15 50 or 100 see permit For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-250 last revised April 1], 2013 Page 1 of 2 STORM EVENT CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): _ Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: If you report a sgmple value in excess. of the benchmark,, you must implement Tier 1, Tier 2, or 11er 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 11 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 cony of this AMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitoring period in the case o "No Discharge" reports) Division of Water Quality Attn: 0W'Q 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 Acument and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel proper] gat r a evaluate the information submitted. Based on my inquiry of the person or.persons,who manage the system, or those persons directly re risible f gat i g t info mation, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there ar si nificar enalt for bm' ing fad information, including the possibility of fines and imprisonment for knowing violations." ature of Permittee) 8 / (a (Date) Additional copies of this form may be downloaded at: http://r)ortal.ncdenrorg/web/wq/ws/su/nl)dessW#tab-4 S WU-250 last revised April 11, 2013 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 As Date submitted CERTIFICATE OF COVERAGE No. NCGO8 0 9 FACILITY NAME L j&K -TRuo<w(, iNc. COUNTY tjA) So j PERSON COLLECTING SAMPLES 2D1 L-113 I DWELL LABORATORYPftf-F Ld ' YnCAL Lab Cert. # f,24/ Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR 0112'9 1 t') SAMPLE PERIOD ❑ Jan -June [&July -Dec or ❑ Monthly" (month J DISCHARGING TO CLASS [71ORW E]HQW []Trout []PNA E]Zero-flow [:]WaterSupply EISA ReCEIqED Other FEB PLEASE REMEMBER TO SIGN ON THE REVERSE FILF-S SERoWALC-rjoN El No discharge this period'. Outfall 4 !;p 'P -0-1 .-and'Grease/TPH EPA New Motor'OII Usage, H" 'S Collected . .. ..... .. P97 AMM9, T I N 'd AA n �M -th I.. n n u a -.4Ve t St 1-7 -an ar ,u e o age: a yr miv, L 00.c : Or ..e PR t in 7 . /V 9 9 14 73 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes —no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Seconda . ry Containment Areas at Petroleum Bulk Stations and Terminals 5 - -- . z : , - � - . - - 0 55 ob 7 8 d ,Solids,""--- , H t0d" a�e;.Oi '-;49 SUsoe' fi 'e" '` " 1" k- -Ad Grease C' 00400 �qa.sp No TP L mg. st,a idbf"n it .Permit I rn 1. -5 !;6K%1U0sPe-permi 0. For sampling periods with no discharge. at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-25( ?M? STORM EVE.;, ( CHARACTERISTICS: Date o 97 iS�_(first event sampled) Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): 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 I REQUIREMENTS. SEE PERMIT PART It SECTION B. + 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE 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 dag of receipt of the lab results or at end of monitoring period in the case of "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 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 gatherin information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there ayp signif)cant penalties fo�mitting false information, including the possibility of fines and imprisonment for knowing violations." nature of Perm /d 7 (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wcl/ws/su/npdessw#tab-4 11 + SWU-250 last revised October 25, 2012 Do I of 7 -� MCDER. Stormwater Discharge Outfaii (SDO) Qualitative Monitoring Report ' For guidance on filling out thisform, please visit. http://12ortal.ncdenr.org/web/wgfws/su/ni2dessw#tab-4 Permit No.: N/CI-012/ 0 / o/ p/ o/Q/ or Certificate of Coverage No.: FacilityName: LISP TUC�kirJG i oJC- County: bN,Co rl __ _ _ Phone No. 76c/ - 02 7d - 610 Inspector: Date of Inspection: 10 /,-� 7 / LS Time'of Inspection: /% I / S19e�21 Total Event Precipitation (inches): Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) Yes ❑ No Please verify whether Qualitative Monitoring must he performed during a "representative storm event" or "measureable storm event" Crequirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. A "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter interval is representative for local storm events during the sampling period, and the permittee obtains approval from the local DWQ By this sigy(Atu}b, I ceroff-that this repdrt is (Signature of Permittee or aI Office. to and complete to the best of my knowledge: Pagel of 2 1. Outfall Description,: Outfall No. L^ Structure (pipe, ditch, etc.) Receiving Stream: _ CA-6>1 &J -'IZii-NGN _ {. Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the dis (Iight, medium, dark) as descriptors: using basic cplors (red, brown, blue, etc.) and tint 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): /V0 NF 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very Cloudy- 1 (j2D 3 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 0 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes 8. 9. Is there an oil sheen in the stormwater discharge? Yes No Go) Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition maybe indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 sWU-242, Last modified 10/25/2012 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG080000 Date submitted CERTIFICATE OF COVERAGE No. NCGO8.0 I - � 8 FACILITY NAME L15L aRa0<lQ(, IAJC, COUNTY dN PERSON COLLECTING SAMPLES i5o LABORATORY jkC Z&,4LV-nCj4L- Lab Cert. # Comments on sample collection or analysis: Pal A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR .2015- SAMPLE PERIOD Jan -June [:] July -Dec or N Monthly' Lmon±l DISCHARGING TO CLASS []ORW []HQW [:]Trout []PNA oZero-flow E]Water Supply EISA 'pother PLEASE REMEMBER TO SIGN ON THE REVERSE PE] No discharge this period' OP aTotl Sus H NeW'MotoFbwbiiiii��1� leii�e az St � -�' E "'lVidt Ann r an 6rd'u ts nj dd.16641(SGT:-'H q4 �'Wit "r 1 6 6 162 /2 015 L- —12 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yes _no (if yes, report your analytical results in the table ininiediately below) I Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals 00460�- A "N :Sam e;Cd Iect 6d '0" d' d 1,.a /ddF A664(SG'EM darT�H 4 1st mit :Pefmi#li 0, r, 0 se6�perrn t, For sampling periods with no discharge. at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-25 Ir -wised 1 r 25, 2012 Page 1 of 2 STORM EVE.. o' CHARACTERISTICS: Date � - (first event sampled) Total Event Precipitation (inches): _/ / +-� Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Nate: If you report a sample value in excess of the benchmark, you must implement Tier I, 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. e 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTI N o 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: Mall an ariainal and one cop" of this DMR1 includincr all "'No Discharge" reports within 30 days of receipt of the lab results for at end of monitorina Period in the case of "No Discharae""reportsl to: Division of Waier_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 ar ni ant pe Iti s for submitting false information, Including the possibility of fines and imprisonment for knowing violations.". ature of (Date) Additional copies of this form may be downloaded at: http://portal.ncd_enr.org/weblwct/ws/sulnpdessw#tab-4 SWU-250 last revised October 25, 2012 RECEIVE® A-A&j�' lr MCDENR . CENTI� L INI1_EStormwater Discharge Outfall (SDO) DWR SECTION 00A Qualitative Monitoring Report forguidance on filling out this form, please visit: http;f IporWI.ncde,ar.Q g/web/wq,lws-isu.1, des5w#tab-4 Permit No:: /��/�_l v/ of �/� or Certificate of Coverage No.: W�JWV/ Facility Dame: L I SP 7ma K I M 6 / niC, County: u (,j Phone No. - 701-1 - 27a - 6101 Inspector:l�awlLt- Date of Inspection: 60 Time of Inspection: - S � LI S, A M Total Event Precipitation (inches): 1 W Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) Yes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or "measureable storm event" (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits`require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. A "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The previous measurable storm event must have been at Ieast 72 hours prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter ; interval is representative for local storm events during the sampling period, and the permittee ' obtains approval from the local DWQ Regional Office. By this sigg4ure,kertify tit report is accurate and complete to the best of my knowledge: re of Permittee Designee) Page 1 of 2 SWU-242, Last modified 10/25/2012 1. Outfall Description: Outfall No. Structure (pipe, ditch, etc.) , Pi �E Receiving Stream: Describe the industrial activities that occur within the outfall drainage area: 2. Color::Describe'the color of the discharge using basic colors ed, brown; blue, etc.) and tint (light, medium, dark) as descriptors: dT 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): _ /i a N 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 3 4 5 F 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 2 . .3 4 . 5 b. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1. is no solids and 5 is extremely muddy: L% 2 3 4 5 7.11 is there any foam in the stormwater discharge? Yes No S. is there an oil sheen in the stormwater discharge? Yes No 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 5WU-242, Last modified 10/25/2012 STORMWATER DISCIIARC.E ouTFALL (SDO) MONITORING REPORT GENERAL PERMIT NO. NCGO80000 CERTIFICATE OF COVERAGE NO. NCG08 01510 ITS", FACILITY NAME W 0 j') X, V j L 1 5"1'-' Tr I"1,',RSONCOLLECTING S-A—MI'LE(S) I d6jjot, CERTIFIED LABORATORY(S) 6o f�e,, T.,_ SAMPLES COLLECTED DURING CALENDAR YEAR: lqq-s (all samples collected during a calendar year, shall be reported no later than January 31 of the following year) COUNTY PHONE N0- _70 Q, -, Z, 71t, - Wq By this signature, I certify that this report is accurate and complete to the best of my knowledge Part A: Specific Monitoring Requirements for stormwater discharges from secondary containment structures associated with Petroleum Bulk Stations and Terminals and stormwater discharges from Oil Water Separators Outfall 00556: 00545 00070`:: : 46000. '0040:.' .N �SW lds i moldWILL . MG:unit : .Z -7. PT7,. Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? e-y-e-s- —no (if yes, complete Part B) Part B: Vehicle Maintenance Activity Monitoring Requirements Dote 1.8U0 Nn Sample 'iTutat oil lAadjotal ;Ethylene D New Grease (e, C, 01 'Y'" r r 11�. C 4 0 or R 0 UK a Ir'n, 0. 3r,-G < L0t2lz. STORM EVENT CHARACTERISTICS: P, Total Event Precipitation (inches): Event Duration (hours): j o b (if more than one stonn event was sampled) Total Event Precipitation (inches): Event Duration (hours): OCT 19 1995 E N -V N1 A %G E,%l E Nf T '\ FAyL77_'_-L`ILLE REG. OFFICE Mail Original and one copy to: Attn: Central Files Division of Environmental Mgt. DEFINR P.O. Box 29535 Raleigh, NC 27626-0535 Form MR08