NCG080023_MONITORING INFO_20181203

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
�V C� D� ou -3
DOC TYPE
❑HISTORICAL FILE
C� MONITORING REPORTS
DoC DATE
o a � � � � a- � 3
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted 11/26/18
CERTIFICATE OF COVERAGE NO. N0008 0 0 2 3
FACILITY NAME Winston-Salem Transit Authority _
COUNTY Forsyth
PERSON COLLECTING SAMPLES Ben Robinson
LABORATORY Meritech, Inc. Lab Cert. t# 165
Comments on sample collection or analysis: D
DEC 0' 2018
SAMPLE COLLECTION YEAR 2018
SAMPLE PERIOD ❑ Jan -June X❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
®Other Class C
PLEASE REMEMBER Tn Str,N nN THE RFVFPcF 4
Did this facility perform Vehicle Maintenance Activities using more'than q5,rgaAdNbf new motor oil per month? X yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
❑ No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr ,
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo .
Benchmark
-
50 or 100 see permit
Within 6.0 _ 9.0
15
-
SDO-1
1 11/12/18
1 20 m /L
7.32
<5 m /L
460
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
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-250 last revised April 1 % 201
Page I of 2

STORM EVENT CHARACTERISTICS:
Date 11 /26/18(first event sampled)
Total Event Precipitation (inches): 1.58"
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 AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART II SECTION B.
+ 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of_this_DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (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
direly 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
th r� are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations:"
of Permittee)
I
(D te)
itional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/suZnpdessw#tab-4
S W 11-250
last revised April 11, 2013
Page 2 of 2

Semi-annual Stormwater Discharize Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted 6122/18
CERTIFICATE OF COVERAGE NO. N0008 0 0 2 3
FACILITY NAME Winston-Salem Transit Authority
COUNTY Forsyth
PERSON COLLECTING SAMPLES Ben Robinson
LABORATORY Meritech, Inc. Lab Cert. tt 165
Comments on sample collection or analysis:
1�N 2
SAMPLE COLLECTION YEAR 2018
SAMPLE PERIOD X❑ Jan -June ❑ July -Dec
or ❑ Monthly"_ (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
®Other Class C
PLEASE REMEMBER TO SIGN ON THE REVERSE -)
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? X yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
❑ No discharge this period'
Outfall
No. •
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
56lids,.mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 6.0 — 9.0
15
SDO-1
5/29/18
14.4 m /L
7.24
<5 m /L
460
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date
Sample Collected,
mo/dd/yr
005S6
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 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.
SWU-250 last revised April 11, 2013
Page I of 2

STORM EVENT CHARACTERISTICS:
Date 5I291i 8 (first event sampled)
Total Event Precipitation (inches): 0.42"
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 copyW 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 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
ther"re significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee}
c2 g
(Cate)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SW U-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. NCG080000
Date submitted 1/24/18
CERTIFICATE OF COVERAGE NO. NCG08 0 0 Z 3
FACILITY NAME Winston-Salem Transit Authority
COUNTY _Forsyth
PERSON COLLECTING SAMPLES Ben Robinson
LABORATORY Meritech, Inc. Lab Cert. #1 165
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR 2017
SAMPLE PERIOD ❑ Jan -June ❑X July -Dec
or ❑ Monthly'_ _ _ -(month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
X]other Class C
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? X yes _no
(if yes, report your analytical results in the table immediately below)
RECEIVEDPart A: Vehicle Maintenance Areas Monitoring Requirements (If applicable) ❑ No discharge this period'
JAN 2 9 2018
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530 .:
00400 ,
005S6
Total'Suspended
Solids, mg/L
pH,
Standard units
and Grease/TPH EPA
Metho1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within. 6.0,-,9.0 '
15...:
-
SD4-1
12/20/17
26 m /L
7.14
<5 m /L
460
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date
Sample Collected,
mo/dd/yr .
00556
00530 a.
Y 00400
Non -Polar oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100.see permit .
6ff 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.
SWU-250 last revised April 1], 2013
Page I of 2

STORM EVENT CHARACTERISTICS:
Date 12/20/17(first event sampled)
Total Event Precipitation (inches): 0,381,
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 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 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 4r� significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(54Kattire of Permittee)
1 �r
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr,or,gZweb/wq%ws/su/npdessw##tab-4
SWU-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
Date submitted 1/24/18
CERTIFICATE OF COVERAGE NO. NCGO8 0 0 2 3 SAMPLE COLLECTION YEAR 2017
FACILITY NAME Winston-Salem Transit Authority SAMPLE PERIOD ❑ Jan -June X❑ July -Dec
COUNTY Forsyth or ❑ Monthly' (month)
PERSON COLLECTING SAMPLES Ben Robinson DISCHARGING TO CLASS ❑ORW ❑HQW [:]Trout❑PNA
LABORATORY Meritech, Inc. Lab Cert. # 165 ❑Zero -flow [jWater Supply —]SA
Comments on sample collection or analysis: X❑Other Class C
PLEASE REMEMBER TO SIGN ON THE REVERSE --)
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? X yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
❑ No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530,
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo..
Benchmark
-
50 or 100 see permit
Within 6.0 — 9.0
15
-
SDO-1
12/20/17
26 m /L
7.14
<5 m /L
460
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556
00530 _
00400
Non -Polar Oil and Grease/TPH EPA Method .
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 — 9.0
I For sampling periods with no discharge at any single outfa11, you must still submit this discharge monitoring report with a checkmark here.
5WU-250 last revised April 11, 2013
Page i of 2

STORM EVENT CHARACTERISTICS:
Date 12/20/17(first event sampled)
Total Event Precipitation (inches): 0.38"
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 PARTA AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an original and one coov of this DMR, includina all "No Discharae" reports, within 30 dovs of receipt of the lab results for at end of monitorina period in
the case of "No Discharae" 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. 1 am aware that
there ar flignificant penalties for submitting 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/wq/ws/su/npdessw#tab-4
SVI'U-250
last revised April 1], 2013
Page 2 of 2

1 - EnviroLinc
Environmental Compliance Solutions
RECjE�'' a
JEFD
March 21, 2017 U48 3 p 2W
Division of Water Quality owR $EL FILES
Attn: Central Files orlon,
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Subject: Stormwater Discharge Outfall Monitoring Report
Winston-Salem Transit Authority
COC Number NCG080023
Forsyth County
Please find enclosed the Stormwater Discharge Outfall Monitoring Report for the
referenced site located at 1060 North Trade Street in Winston-Salem, North Carolina. If
you have any questions please contact us at [phone].
Yours truly,
�IR-45
Lynne Hays
100 N Tryon Street B220 PMB 360 • Charlotte, NC 28202 • Phone: [phone]

Semi-annual Stormwater Discharee Monitorine Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted 3/21/17
CERTIFICATE OF COVERAGE NO. NCG08023
FACILITY NAME Winston Salem Transit Authority
COUNTY Forsyth
PERSON COLLECTING SAMPLES Lynne Hays
LABORATORY R&A Lab Cert. t# 34 Comments on sample collection or
analysis:
Part A: Vehicle Maintenance Areas Monitoring Requirements
SAMPLE COLLECTION YEAR 2014
SAMPLE PERIOD Jan -June X July -Dec
or Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
❑ No dischorge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530•
00400
00556
Total Suspended
Solids, mg/L
„pH;
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L.,
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 610 — 9.0
SDO # 1
11/29/16
33.5
7.2
<5
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? x 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
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil'and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 - 9.0
' ror sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last reti,ised October 2-5, 2012
Pa-e 1 42

STORM EVENT CHARACTERISTICS:
Date (first event sampled): 3/29/16
Total Event Precipitation (inches):.70
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.
• T1ER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES xNO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an ariginal and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the tab results (or at end of monitoring_ period in
the case of "No Dischorg_g 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 significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Winston Salem Transit Authoritv
(Signature of Permittee) jDate) -1-1
Additional copies of this form may be downloaded at: http.),jportal.ncdenr.org/webj�yq/ws/su/npdessw#tab-4
SWU-250 last revised Octohcr 25, 2012
Page 2 of 2

Semi-annual Stormwater Dischage Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
nc&0q 66D%3 Date submitted 3/31/16
CERTIFICATE OF COVERAGE NO. NCG08023 SAMPLE COLLECTION YE 6ne
FACILITY NAME Winston Salem Transit Authority SAMPLE PERIOD X Jan-J-Dec
COUNTY Forsyth or Monthly (m
PERSON COLLECTING SAMPLES Lynne Hays DISCHARGING TO CLASS ❑ORW ❑HQUI
LABORATORY R&A Lab Cert. # 34 Comments on sample collection or > wpn ❑Zero -flow [�
analysis:
APR 0 5
CENTRAL FILES
Part A: Vehicle Maintenance Areas Monitoring Requirements pV' R SECTION
❑Other_
❑Trout
iter Supply
0
[:]PO OBA
PLEASE REMEMBER,*O SIGN ON THE REVERSE 4
No discharge this period'
Ou�tfalll
No.
ix°"Date'
.:.
Sample Collected,
00530
-
`"WTToSt�JIS`u`7'_"e'6"d9'd
s_, mg/_L
OQ400
;* 00556 s
pH,
�...,..NewjMoto.r
Standard unitsMetf�od
`RNon Polar Oil a Grease%,TPH EPYA
A 64 (SGT=HEMS; mg/L';_taverage
`'"� g ,.
O'iliU.sa e� Annual
gal/�mo
Benc`hm �,1
50,or 100 seep'{ a mite
Wit}iin 6:U 9 U
� 15'
v , t -
SDO #1
3/19/16
109
7.5
<5
V
Did this facility perform Vehicle tenance Activities more than 55 gallons of new motor oil per month? x yes no
(if yes, report.your analytical results in t e a e immediately below)
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals
Outfall
� ..
(` Date
mple Collected; "
.r.--ni � � T'-[9tv 'rJIF
Non-PolarOil`and.Gr��ease/TPHaEPA IVlethods`.
(SG�T�HEMj, mg/L
-0ti '_'�1f �.
' '�,Tf—o—fra—ls
yed Solids,
`
� � �
P pH'64
Standard units
P mit Limit
_ w iM
see=permit
6.0 — 90 RAN
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 October 25, 2012
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date (first event sampled): 3/19/16
Total Event Precipitation (inches):.11
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 Z 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 EXCEEDANCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? x YES NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? xYES ❑ 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 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."
(Signature of Permittee)
16
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/­ws/­su/npdessw#tab-4
S W U-250
last revised October 25, 2012
Page 2 of 2

w
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Q Date submitted 12/2/15
)I1
CERTIFICATE OF COVERAGE NO. N0008023 Y � c� O 1J 0 0,c-�3 SAMPLE COLLECTION YEAR 2015 C.14 'Oak
FACILITY NAME Winston Salem Transit Authority
COUNTY Forsyth
PERSON COLLECTING SAMPLES Lynne Hays
LABORATORY R & A Lab Cert. # #34
Comments on sample collection or analysis:
SAMPLE PERIOD Jan -June x July -Dec
or Monthly'_ month_
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
RECEIVED [:]Zero -flow ❑Water Supply ❑SA
xOther C
Dec o7 Za15
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL FILES
Did this facility perform Vehicle Maintenance Activities using more than 55 gallonsDWew9mol"60NI per month? x yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
.60530
00400
00556
Total'Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM); mg/L
New Motor Oil'Usage, •
Annual average gal/mo
Benchmark
-
100 see permit
.'Within 6.0 — 9:0
15
-
SDO #1
10/27/15
79.0
8.07
79.0
>55
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556
00536
00400
Nan -Polar Oil and Grease/TPH EPA Method.
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units .
Permit Limit
-
15
50 or 100 sep-permit
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-250 lest revised April 1 1 . 2013
Pa,,c 1 42

STORM EVENT CHARACTERISTICS:
Date 10/27/15 (first event sampled)
Total Event Precipitation (inches):.55
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 x
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy pf this DMR, including all "No Discharge" reports, within 30 days of receipt o the !ab results f 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 significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Lynne Hays for Winston Salem Transit Authority 12/2/15
(Signature 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 April 1 I, 2013
Page 2 42

Semi-annual Stormwater Discharge Monitoring Report
+ - for North Carolina Division of Water Quality General Permit No. NCG080000
Q16 j� Date submitted 2/13/15 / � � —
CERTIFICATE OF COVERAGE NO. NCGO8023 U V V D3_ SAMPLE COLLECTION YEAR 2
FACILITY NAME Winston Salem Transit Authority ECEIVED SAMPLE PERIOD x Jan -June' ❑July -Dec
�
COUNTY Forsyth or FES 1 6 201cj DISCHARGING TO CLASS ly nr
PERSON COLLECTING SAMPLES Lynne Nays
❑ORW ❑HQW ❑Trout ❑PNA
Zero -flow Water Supply 5A
LABORATORY R & A tab Cert. # #34 CENTRAL FILES ❑ ❑ pp y ❑
Comments on sample collection or analysis: DWR SECT10 I Ma xOther C
L Mv, C
CI
LEASEREMEMBER TO SIGN ON THE REVERSE �
v
Did this facility perform vehicle Maintenance Activities using more than 55 gallons of new motor oil per month' x yes —no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
❑ No discharge this period'
Outfall
Date
0053U
0040000556:,
" `,:
Total`SuspendedF`
_ pH
Non Polar Oil'and=Grease/TPH'EPA
NewaMotoOilUsage,�
No.
Sample,Coflected;
' _- y
Solids, rng/L
,Standard°units-'
MetFiod 1664 (SGTYHEM)*mg/L -
Annual average§gal/,Trio
Benchmark :
' -
100see p�errriit
�. ''Within 6.0-9:0
15
,''. � Y;: •
SDO #1
1/23/15
58.8
8.24
7.9
>55
r
Part B. Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (if applicable)
Outfall
*.
No.:
Date
Sam le Collected,
mo/dd/�y�
'.00556;
; 00530
U0400
Non Polar Oil:and Grease/,TRH EPA Me#hod
1664(SGT-FIEM) mg/L
Total Sus eridedyi5oli'ds,_
.�. >mg/L" ...
Jd ,y� y < u
;, Stan�dunits w]
Permit Limit
`^
50 ar 100 see. fiermit.
?15 P 90 s
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 Iasi revised April 11, 2013
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date-1/23/15 (first event sampled)
Total Event Precipitation (inches):.46
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 it SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES NO x
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 rece. t o the lob 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 significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
P�—
Lynne Hays for Winston SalemTransit Authority 113 15
(Signature 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 April 11, 2013
Page2of2

Ir
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted 8/12/14
CERTIFICATE OF COVERAGE NO. NCGO8023
FACILITY NAME Winston Salem Transit Authority
COUNTY Forsyth
PERSON COLLECTING SAMPLES Lynne Hays
LABORATORY R&A Lab Cert. # 34 Comments on sample collection or
analysis:
Part A: Vehicle Maintenance Areas Monitoring Requirements
SAMPLE COLLECTION YEAR 2014
SAMPLE PERIOD Jan -June x July -Dec
or Monthly' Jul month
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
RECEIVED ❑Zero -flow ❑Water Supply []SA
LJ ❑Other
AUG 15 2014
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL FILES
DW018OG ❑ No discharge this period'
Outfall _
-No;
Date
Sample.Collected, P•
mo/dd/yr•
-=. '00530
00400
00556"
"
' ` Total:Suspended
Solids; mg/L'",
pH; -
Standard units.
Non Polar Oil and Grease/TPH EPA
.Method 1664 (SGT:HEM); mg/L-: ",
New Motor;Oil .Usage;
Annual average"gal/mo.
Benchmark
-
50 or100 see permit
Within 6.0 = 9.0
SDO #1
7/15/14
9.0
7.0
<5.0
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? x 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
i�Outfall�� `,
No
"� :'�* dF°
` -:; Date :�
Sain `le'Collected�;.
�: 1
-V.Y-','o,c1k—•. .e:..^t,
„h{ 00556
00530
040
•5 f" 0 0 ;
RN'6n=Polar:Oil°:and Grease TPH EPA Meth'od``;
h ` �. _�.:. v' .,, .�iM,.
_��. 1664, SGTaHEM1 m L -
•'f'rk-� -( . l� g/ S .i
,TotalrSus eride'd:5olids
4K�'hA,�.;•..
+;r �.. "�,- ..r4._v, =i�S�.dP.
> _mp L
6� b/ ..{:x .:"i:6.k, uF �:<F i�.1
'" H/ �
R'3•�-- �� ,��•X:
.et.
� `Staridard�urii
Permitlimit
j
r +a, :15
'50 or 100:'see permit _
6 0 7,9.0
I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised October 25, 2012
Page I of 2

STORM EVENT CHARACTERISTICS:
Date (first event sampled) 07/15/14
Total Event Precipitation (inches):.23
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? x YES NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? xYES ❑ 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 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 penaI s for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Lynne Hays for Winston Salem Transit Authority 8 12 14
(Signature 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

ILI
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted 7/17/14
CERTIFICATE OF COVERAGE NO. NCGO8023 j 1' SAMPLE COLLECTION YEAR 2014
FACILITY NAME Winston Salem Transit Authority ECE+ V E[)AMPLE PERIOD xJan-June ❑ July -Dec
COUNTY Forsyth JUL 2 1 ZQi$ or Monthly _ April (month)
PERSON COLLECTING SAMPLES Lynne Hays DISCHARGING TO CLASS ❑ORW ❑HQW []Trout n ._,fVTRAL ❑PNA
FILES
LABORATORY R&A Lab Cert. # 34 Comments on sample colkec#io2D] �.ES ❑Zero -flow [:]WaterSupply ❑SA
analysis:
Part A: Vehicle Maintenance Areas Monitoring Requirements
WQ/80G ❑other
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
❑ No discharge this period'
.Outfall . ,
No.
Date
-5arnple:Collected;,
mo/dd/yr ,
. ; 1 00530 , , , ',
• 00400
: 00556
Total Suspended '`'
Solid`s; mg/l
: pH, ";
Standardtunits'
Non=Polar.0iland Grease/TPH°EPA
Method.1664(SGT-HEM); mg/L . s,
;:New Mo. tor OiLUsage,'.
. ';Annual.average gal/mo _
50'ar 100see permit
'Within 6Az, 19,0,
SDO #1
7117/14
14.5
7.3
<5.0
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? x 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
Outfally =
l:
µ4
'
Date
',.. -..�
Sam le Collected,
p .;_�h< �
�+; "i, t.a
Imo dd r `�>1664
r r :00556� a r'
�,;L '' "0053Q y', y�rr00400"
q '
Non=Polar•Dil and Grease/aTPH.,I P,A Method
;:�
i J -a4 Y' �. �:,,,. tP
SGT=HEM m L'"
`:.t44iY�iY„vw y. [;,3 k'
�.yTotal;Sus ended Solids,
s, ,.:.<'. .' r
"aS `:.,
i
„¢^. tih .T'� W { jk•�,"{ Sep Y
+ # �� : �pH„
;Standard units'
4lY �:4�
PermiiTL1iR '
�.itii'A(-'Y�AW-:
M�R7;.r,:tY50orh100,°see
i
f.W bLF.R ,'°"
ermit .'4
Oe
,>,:
' .
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 October 25, 2012
Page I of 2

1
STORM EVENT CHARACTERISTICS:
Date.(first event sampled) 06/19/14
Total Event Precipitation (inches):.30
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: !f 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? x YES NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? xYES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an on inal 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 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."
1.714—
Lynne Hays_ for Winston Salem Transit Authority
(Signature of Permittee)
7 17 14
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
S W U-250
last revised October 25, 2012
Page 2 of 2

-jk
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
0
lr� 1%aIxs Date submitted 5/27/14 CERTIFICATE OF COVERAGE NO. NCG08023 RECEIVED
FACILITY NAME Winston Salem Transit Authority MAY 3 0 ZU14
COUNTY Forsyth
PERSON COLLECTING SAMPLES Lynne Hays CENTRAL FILES
LABORATORY R & A Lab Cert. # #34 DWQIBOG
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR 2014
SAMPLE PERIOD [] Jan -June Ej July -Dec
or xMonthly' May (month)
DISCHARGING TO CLASS [:]ORW E:]HQW EjTrout [:]PNA
oZero-flow E]Water Supply []SA
xOther C
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? x yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (if applicable)
0 No discharge this period'
r
.00530
u,
4064
QQ 5
�,i-qota �SR­'­ n�
3' "peide­
's and djuin its
�A, t
6 15 r. 0 i I a n d g1tow-pp A�'
Met fr&d,166�4'(SqTr-�tl
q, a O.W.Us5gej..,�,
MIP4..�ave agei
'9 M 0!
cKiii
Wi 9'0"'
15
S'
SDO #1
1 5/10/14
29
7.4
6.0
>55
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (if applicable)
�16-6,ff jll-
► KE-5
Sam le Collectedtfion-Po
A - R'
i 1d%7reasejT.PHEPA M t
4; F r, d
)01 Wdiu "�3 W,
',, J.�( E0 C3
C So
Urial'� �sp d dT �lids,
SM
p
�H '
VS6 o Kd units
4r
rth. LjhiivAl
A
157, 1, 7
j6'r7f0=9see,' er7MtFF1j7_M
!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.
SWU-250 last revised April 11, 2013
Page I of 2

STORM EVENT CHARACTERISTICS:
Date 03/03/14 (first event sampled)
Total Event Precipitation (inches):.14_
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 Il SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES x NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES x NO ❑
REGIONAL OFFICE CONTACT NAME: Bethany Georgoulias
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 significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Lynne Hays f Ar nston Salem Transit Authority 5 27 14
(Signature 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 April I 1,2013
Page 2 of 2

i
EnviroLinc
Environmental Compliance Solutions
May 27, 2014
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Subject: Stormwater Discharge Outfall Monitoring Report
Winston-Salem Transit Authority
COC Number NCG080023
Forsyth County
Please find enclosed the Stormwater Discharge Outfall Monitoring Report for the
referenced site located at 1060 North Trade Street in Winston-Salem, North Carolina. 1f
you have any questions please contact us at [phone].
Yours truly,
Lynn Hays
109 Gentle Pond Court • Winston Salem, NC 27107 • Phone: [phone] Fax: [phone]

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted 4/30/14
CERTIFICATE OF COVERAGE NO. NCGO8023
FACILITY NAME Winston Salem Transit Authority
COUNTY Forsyth
PERSON COLLECTING SAMPLES Lynne Hays
LABORATORY R&A Lab Cert. # 34 Comments on sample collection or
analysis:
Part A: Vehicle Maintenance Areas Monitoring Requirements
SAMPLE COLLECTION YEAR 2014
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or Monthlyl Aril month
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
RECENED ❑Other
MAY O �� �UlePLEASE REMEMBER TO SIGN ON THE REVERSE
CEpW IQ1Q SOGEv
No discharge this period'
tk^ .:N,.;1
Outfall
k_ S.' T -,.ks?
Yk ,Date
'y-ern )♦ f t�
_,# 7"00530 �t ,'
,1.
T' F
.r:y 00400
`%y �.i q`5
00556 t F
*vd»°s+. Y'."
.i1r,
a1i,1..
iS R'•t
..r d N'-• 'hl
SaplCollected
'Total5upenNo e
?.
�s pdr
Non P�'-•
-
ia9la7laei-
F
unitsj
SGT-HStadad
Methods1664}
;A'Ne�rnwuaMl�aotoerr4a0
f
g
g o
�,,iy
°1366' hmark
�^;-Lr -..u, t•i n.�`raa♦
*r-.�_:z
<50.or 200�see
_
Within:6' 0"4
15
.
�z �,F
ermit =
,:
�.
SDO #1
No
No
No Discharge/Inability
No Discharge/Inability to collect
Discharge/Inability
Discharge/Inability to
to collect sample
sample
to collect sample
collect sample
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? x 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
-K '.; -i... .f
Outfall�
i _.r.- F-� __•�-.-.,-S..zY ,:. -
t
Date'V_iUD5S6
�{
Nr<�: i Qrl. 1T ,. �. ; yf
}`xY "
:LR y�.:.-..--•-•-•-., rl.
No�Sample
b.
.
Eollected,
j+ i p' � ± 5+^' y� Y
Non Polar OBI andG_reyase/tTPHfEPA,Method
�} v� A- 4+".�L�-TP i "'S Y-
Ir.�-Total�5uspended Sods;
FIna
'mo da`r
lY._
_6 4 SGT`-HEM m L_2 ` 4:
},
",mOR,
Standard units=`t
,.H� ._ .I. ,:._._
_ ...._:.�......; �( _gl,.
�... � • .k max.:....
eras-:
er # t..
P mi Limi.:
itr,^.r<s -:ro
s-Yt"`Dk
�'.,'iL&.',r- -fli "d,: �•,: �, `k�,t"d r�•f` ,+- y-.. c.�
S r
;q�;- '-�+'i ..vr'.:x.,�. uy,iv:'rr
ki^ i ermit
f; :•, .., :i�.„ -9
Perm 17
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 October 25, 2012
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 rer 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? x 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 off "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 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."
Lynne Hays for Winston Salem Transit Authority 4 30 14
(Signature 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, 20t2
Page 2 of 2

EnviroLinc
Environmental Compliance Solutions
April 30, 2014
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Subject: Stormwater Discharge Outfall Monitoring Report
Winston-Salem Transit Authority
COC Number NCG080023
Forsyth County
Please find enclosed the Stormwater Discharge Outfall Monitoring Report for the
referenced site located at 1060 North Trade Street in Winston-Salem, North Carolina. if
you have any questions please contact us at [phone].
Yours truly,
Ly e Hays
109 Gentle Pond Court 0 Winston Salem, PVC 27107 0 Phone: [phone] Fax: [phone]

r
.-4
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted 1/24/14
CERTIFICATE OF COVERAGE NO. NCG08V3SAMPLE COLLECTION YEAR 2014
FACILITY NAME Winston Salem Transit Authority RECEIVED SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
COUNTY Forsyth j` or xMonthiyl_January (month)
PERSON COLLECTING SAMPLES Lynne Hays 0 3 2014 DISCHARGING TO CLASS ❑ORW ❑HCtW ❑Trout ❑PNA
LABORATORY R & A Lab Cert. # #34 ❑Zero -flow ❑Water Supply ❑SA
Comments on sample collection or analysis: G�C)WQieOGEs xOther C
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? x yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
Ej No discharge this period'
xOutfall'
f Date ,' Fir
i@-
t `r0053Qtix0040U
� h"v'lY "'.'�I'tdr1.' +y' „r,
�Tatal;5uspendedW,
; 0055fi"�.#
r `�I-4 �.i'- �51CII'1541FAR -.. -
��. :;
No +
SamPI'9Colle2ted '
�k
f; " OF[;
N'o =Polar Oil and�Greas.e/TPHiEPAk
New Motor O�U=',':mo
d r
Solids m'
SStndard +
:Method 1fi64 5EM L'
Annual
units
m
a�era mo
War k,-
° r c a
`100 see;pefmit
rBeAch_..>
SDO #1
1 12/14/13
784
7.82
172
>55
SDO #2
12/14/13
304
9.07
25.3
>55
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
all
Date _.-
!e Collected'
p� E;,,..
c
RW 00556 �F
NonPolar#Oii and Grease/TPH EPA Method
R."
16& (SGT,;HEM),Standard
} OOS3Q 4
Total Suspe`n'di�d'So ids,
00400
pH,
units
`P re mit�Limit
r.
., "49' � 15"W. ATy..,. �;t"
50,o,r 100 seePpermit • ,;t, ,I
6 09.0
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 11, 2013
Page I of 2

STORM EVENT CHARACTERISTICS:
Date 03/03/14 (first event sampled)
Total Event Precipitation (inches):.15_
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 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 x NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES x NO ❑
REGIONAL OFFICE CONTACT NAME: Bethany Georgoulias
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 significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
L nne &afor Winston Salem Transit Authority
(Signature of Permittee)
3 31 14
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
S WU-250
last revised April 11, 2013
Page 2 of 2

EnviroUnc
Environmental Compliance Solutions
March 31, 2014
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Subject: Stormwater Discharge Outfall Monitoring Report
Winston-Salem Transit Authority
COC Number NCG080023
Forsyth County
Please find enclosed the Stormwater Discharge Outfall Monitoring Report for the
referenced site located at 1060 North Trade Street in Winston-Salem, North Carolina. 1f
you have any questions please contact us at [phone].
Yours truly,
4 M*
Lynne Hays
log Gentle Pond Court • Winston Salem, NC 27107 • Phone: [phone] Fax: [phone]

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
5>0 b a 3 Date submitted 3/3/14
CERTIFICATE OF COVERAGE No. NCGO8023 R EC g— Jv A t ALE COLLECTION YEAR 2014
FACILITY NAME Winston Salem Transit Authority C IIPLE PERIOD ❑ Jan -June ❑ July -Dec
COUNTY Forsyth MAR � � 201 or xMonthlyIFebruary (month)
PERSON COLLECTING SAMPLES Lynne Hays ^DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY R & A Lab Cert. # 34 Comments on sample collection or CENTRAL FILES ❑Zero -flow ❑Water Supply [:]SA
analysis:
DWQ/BOG ❑Other
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? X yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
❑ No discharge this period1
Outfall=4_#
w� Date
0053Qp�
-00400 ,�
;:00556i
^.�.�a
_^
,.. k
'�t
. sample Collected,
$" �' �
; :,Total;5i spe�ided, .,
�ri �.:�v, =.�i. - '^� �
., _ v ' pH,,, q,.
i.,.':� ' ir.
,Non Polar Oil and GreaselTPH EPA
:�'—. e@rp' r . �:. .- '1 � .mie'n.•
New MotoraClil Usage,
,No ,
i..'iS._
'''���FFFr
v,C �,
".."u
�'mo/lid/yr:M;,_
,�'
,m =,n,' s- .f.'� �
f 'Ls,i•+„i'C
f..,�''�; _� ., '-`"�F.
Standardunits-
�'y�.�,.. C:d
�51... c.:�:
Method 1664�(SGT-HEM]fmg/,LET
BAN 1 5''4. �,j,
t,�� .�+.w-�.
AnnualayerageFgal/mo'
,0r
7�Solids,:mg/L�w�„f
..
r r
Benchiriarkt,
-
,�..
SO or�100;=see
P A
Within"6.0 9 0,Z �
; { wp
�,, M �; _
;pe�mit
,'
t r
SDO #1
February
UNABLE TO COLLECT
UNABLE TO COLLECT
UNABLE TO COLLECT SAMPLE
>55
SAMPLE
SAMPLE
SDO #2
February
UNABLE TO COLLECT
UNABLE TO COLLECT
UNABLE TO COLLECT SAMPLE
>55
SAMPLE
SAMPLE
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
~ Outyfall
r �: :Date�'U
r, F °` D0556 :.;' ''' _
,
-;� .., -c - -�
.F 00530 s
.s.
004d0
.� �-�
`
fir }=F-'r.4 'rt-�'
Sampler -ollected,
�I 4Wd'tM'
Non Polar40il andl�Grease/TPH EPA'=Method
1ti.±. 3' ay. r?4+;?"'r
*
Total Suspended Solids, :. �
r y=
pH,'
V.
/dd/yr "
166,4t(SGT„HEM) /,.�
641,1
Mf
Standard
f'
..r A �
... .
�mg/.L K
.w. units � {
_ Y
Permit Limit'-.
, H !
V r.`
�,....y_"`--
{k-5 orm100,see ermity��
Q
_.,�- .z
6. 9 Q�g,
p .sa—
.091
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 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 1, 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 X NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES X 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 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."
'i
Lynne Hays For WSTA 2 3 14
(Signature of Permittee) (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wg/ws/su/npdessw#tab-4
SWU-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
Date submitted 1/29/14
YUD-, -D
CERTIFICATE OF COVERAGE NO. NCG08023
FACILITY NAME Winston Salem Transit Authority
COUNTY Forsyth
PERSON COLLECTING SAMPLES Lynne Hays
LABORATORY R & A Lab Cert. # 34 Comments on sample collection or
analysis:
SAMPLE COLLECTION YEAR 2014
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or xMonthlyIJanuary (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE -->
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? X yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Raquirements (If applicable)
❑ No discharge this period'
++��_��•, Daut�e ��u"
�,�
00.5311 �.�x��
�..a�+ ;;�.: r004.00,'c��..4
-%a�3S�`
r
,...� uRtl T..h p!I
'�1'otal Susy�pentled
4�u,%ma t+ k .%7 �
' +pHt * °=s�Nogn=Polar
.E34X .'!..H.
,p,M '+T YgG.V".. ��'.A...,g.,, A`.aA'M4HRe'
Oil andGrease/TPH EPA
.Z. R'�j�
- hIFF.
New Motor Oil Usage
� �.!�
++�° 'kNoY
r
'1`
;X. ^.'
r Sainp�lerCollected,
4��S
K, t
!,�uM
K..-{YTtl Y.lHr-�
�.; mo/d/,yr��
. Solids;n�g/LbStandard
•s!Y t 151.
units ",F
.r.i:..
�Y
Methodp�1564,(SGT-HEMj, mg/,L;i�
° Annual
-,;
aXerage gal/�mo
CP A]A?!'Y•iJ1�i....
.,.. `c i -
Benchmarki
MAC fi;"`, Y _
Smk
50 or lOD see,pe"rmit
.-,t_
� ;�Witlik 6 0
'H
` a
,
SDO #1
January
UNABLE TO COLLECT
UNABLE TO COLLECT
UNABLE TO COLLECT SAMPLE
>55
SAMPLE
SAMPLE
SDO ##2
January
UNABLE TO COLLECT
UNABLE TO COLLECT
UNABLE TO COLLECT SAMPLE
>55
SAMPLE
SAMPLE
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
iatfall
911-l"
: ' . Date
§„4
S.a_m ie"Collected
ma/,dd/yr
IS fi'64 ( GreaseM� mHg'LA Nlefhoa
Non- r1 _,,. _nits
7 } F yTot iTSuspeg a solids, .
004UD
W�t�andatd uNo.
;PermielLimit
50 or 10D 5 e
!'D
' 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 i 1,2013
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 1, 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 It 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 X NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES X NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an_origin_al 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 property 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."
6� -k VV ,
(Signature of Permittee)
-A -A[
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
S W U-250
last revised April 11, 2013
Page 2 of 2