HomeMy WebLinkAboutNCG080210_MONITORING INFO_20180301STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v Cic 016(,f)a [ o
DOC TYPE
❑ HISTORICAL FILE
P� MONITORING REPORTS
DOC DATE
❑ ac) I 'k O 3 O [
YYYYM M DD
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO. I /V L& o$ d (,Qd-r2
DOGTYPE Y, HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE ❑ )UV 03
YYYYM M DD
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted 01/11/2018
CERTIFICATE OF COVERAGE NO. NCGO8 0210 SAMPLE COLLECTION YEAR: 2017
FACILITY NAME: Republic Services / GDS Morganton SAMPLE PERIOD ❑ Jan -June ® July -Dec
COUNTY: Burke
RECEIVED or ❑ Monthly' (month)
- -
PERSON COLLECTING SAMPLES: NA MAR 0 1 2018 DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY: NA Lab Cert. # ❑Zero -flow Dwater Supply ❑SA
Comments on sample collection or analysis: CENTRAL FILES ❑Other
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 x 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
00S30
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
-
OF1
NA
NA
NA
NA
54.99 gal/mo.
OF2
NA
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfal I
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 outfall, you must still submit this discharge monitoring report with a checkmark here.
S WU-250 last revised April 11, 2013
Page 1 of 2
STORM EVENT CHARACTERISTICS:
Date: NA (first event sampled)
Total Event Precipitation (inches): NA
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 EXCEEOANCE TRIGGERSTIER 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:
Moil 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:
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 responsib r athering 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 pe €oLsubmitting false information, including the possibility of fines and imprisonment for knowing violations."
M
(Signature of Permittee)
Additional copies of this form may be downloaded at: http:/ip-ortal.ncdenr.o
001
(Date)
S WU-250
last revised April 1 ], 2013
Page 2 of 2
V
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted 4. 311
CERTIFICATE OF COVERAGE NO. NCG08 0210
FACILITY NAME: Republic Services / GDS— Morganton NC
COUNTY: Burke
PERSON COLLECTING SAMPLES: Wade Goossens
LABORATORY: Pace Analytical Lab Cert. # 37712,40
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR: 2017
SAMPLE PERIOD ® Jan -June ❑ July -Dec
RECEIVED or ❑ Monthly' __month
DISCHARGING TO CLASS ❑ORW ❑HQW [:]Trout❑PNA
�� �017 ❑Zero -flow aWater Supply [—]SA
CENTRAL FILES ❑Other
DV/R Si=CT10tj
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 period'
Outfall
No _ .
Date
Sample4Gol.lected. ,
rrio/dd/yr.
00530;_:
A0400
00556
> ,. Total -Suspended ;p-;,pH;Non-Polar
Solids,{mg/L , _
�
uStandard units
Oil and Grease/TPH EPA
Method"1664 (SGT-HEM), mg/L
New.=Motor OiFUsage,
Annual average gal/mo'
Benchmark
-
50 or>100 see±permit_r
IlVifliin'6:0 — 9.0
15
-
1
6/5/17
12.8
6.96
ND
80
2
6/5/17
7.24
ND
110.0
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
a00556`_:;...: ;.
00530
00400; . , .
4'Non=Polar-Oilrand'Grease%.TPH EPA Method
15fi4"(SGT HEM); mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
PermitL'imit
-
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: 6/5/2017 (first event sampled)
Total Event Precipitation (inches): 0.82
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 copypf 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) ta:
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."
M
(Signature of Permittee)
U� l�3lr v
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/nr)dessw##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 Q ality General Permit No. NCGO80000
Date submitted _ / 2-z Z/
CERTIFICATE OF COVERAGE NO. NCG08 0210
FACILITY NAME: Republic Services / GDS — Morganton NC
COUNTY: Burke
PERSON COLLECTING SAMPLES: Wade Goossens
LABORATORY: PACE , Lab Cert. # 37712,40
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR: 2016
SAMPLE PERIOD ❑ Jan -June ® July -Dec
or ❑ Monthlyl
DISCHARGING TO CLASS ❑ORW ❑
[]Zero -flow
❑otherr
HQW ❑Trout
Bwater Supply
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'
Outfal I
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TRH 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
-
1
11-29-16
26.7
6.39
ND
80
2
11-29-16
8.1
6.64
ND
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfal I
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 outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Page 1 of 2
STORM EVENT CHARACTERISTICS:
Date: 11-29-16 (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 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
0 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 It 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 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)
(Date)
Additional copies of this form may be downloaded at: http;//partal.ncdenr,org/web/wg1ws su/npdessw#tab-4
SWU-250
last revised April 11, 2013
Pace 2 of 2
Semi-annual_Stormwater Discharge Monitoring Report
for North Carolina Division of Water Qualit General Permit No, NCG080000
Date submitted / /
CERTIFICATE OF COVERAGE NO. N0008 0210
FACILITY NAME: Republic Services / GDS -- Cleveland Container
COUNTY: Burke -
PERSON COLLECTING SAMPLES: Jeremy Kellam
LABORATORY: ENCO Lab Cert. it 424
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR: 2016
SAMPLE PERIOD ❑ Jan -June ® July -Dec p44
or ❑ Monthly' (mo
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout
[]Zero -flow �ater Supply
❑Other
❑SA
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
-
1
11/30/16
44
Unknown
28.6
80
2
11/30/16
24
Unknown
7.61
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 11 2013
STORM EVENT CHARACTERISTICS:
Date: 11-29-16 (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 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
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an on inal and one copes this DMR, including all "No Discharge" reports, within 30 days of receipt of the lob results (or at end of monitoring period in
the case of "No Discharge" reports) 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 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
(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 11, 2013
Page 2 of 2
`r=_ ENCO Laboratories
Accurate. Timely. Responsive. Innovative.
102-A Woodwinds Industrial Court
Cary NC, 27511
Phone: 919.467.3090 FAX: 919.467.3515
Tuesday, December 13, 2016
Republic Services of NC (RE014)
Attn: Jeremy Kellam
1160 Airport Rd
Shelby, NC 28150
RE: Laboratory Results for
Project Number: Shelby, NC, Project Name/Desc: GDS-Cleveland
CNCO Workorder(s): CZ17821
Dear 3eremy Kellam,
Enclosed is a copy of your laboratory report for test samples received by our laboratory on
Monday, December 5, 2016.
Unless otherwise noted in an attached project narrative, all samples were received in
acceptable condition and processed in accordance with the referenced methods/procedures.
Results for these procedures apply only to the samples as submitted.
The analytical results contained in this report are in compliance with NELAC standards, except
as noted in the project narrative. This report shall not be reproduced except in V1, without
the written approval of the Laboratory.
This report contains only those analyses performed by Environmental Conservation
Laboratories. Unless otherwise noted, ail analyses were performed at ENCO Cary. Data from
outside organizations will be reported under separate cover.
If you have any questions or require further information, please do not hesitate to contact me.
Sincerely,
Stephanie Franz
Project Manager
Enclosure(s)
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SAMPLE SUMMARY/ LABORATORY CHRONICLE
I Client ID: outlall 1
tab I0: CZ17821-01
Sampled: 11/30/16 18:10 Received: 12/05/16 09:30
a
Parameter
EPA 1664A
gpjd batelTlmefsl
17/30/16
Prep Datef'limefsl
12/07116
Analysis Date/Tlmefsl
11:31 17:51
SM i5i0D 19517,
12J01116
l2jonI6
09:40 I '07116 09:40
Client ID: Outfall 2
tab ID: CZ17821.02
Sampled: 11/30/16 18:30 Received: 12/05/16 09:30
rs>ar�
ww
rt®rriar�mrs�e
Parameter
[PA 1664A
1HqADateMmefsl
12J30/16
Pt o DTteIrpmefsl
17J01/16
Analysis Date1T1inefs1
11:31 1?/08/16 0:51
SM25•IOD-1997
12/07/16
IM7116
13M 12/07/16 13:00
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SAMPLE DETECTION SUMMARY
client it); outfatl 1
Lab 10:
C2174321.01
Anal vta
Results
E!M a"
E91
VAB[ l
Method H(otes
Oil & Grease 411CM-SGI) Non-Poiar Malenat
28.6
2.70
S.00
mr17L
EPA 1664A
local Suspely'km S01ids
44
17
17
rng/L
SM 254OD-1997
Client ID: Outfall 2
Lab ID,
CZ17821-02
Ana AC
HC5ul
Fi@9 m
EQ1
units
Method No
pil 6. Grease (UfM-SGr} hIm-Polar Material
7,61
2.70
5.00
mq/L.
EPA 16&IA
Tnlal SusmncjNl Solids
24
l0
10
wolL.
SM 7.540i1-1997
r 1NAL rnjs Icta: leWrea COO to uK srmor As fe ftn 7 oy lnr �,unra:on, nna rnav "+ t tl et !odi I Page 3 of 8
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ANALYTICAL RESULTS
Description: Outfall 1 Lab Sample ID: CZ17821.01 Received: 12/05/ 16 09:30
Matrix: Surface Water Sampled: 11/30/16 18:10 Work Order: CZ 17821
Project: GDS-Cleveland Sampled By:]eremy Kellam
kCiassical Chemistry Parameters
^ - E.-XV Cary r&t &d am m to Or 591)
Analyte,-fCAS Numbed Results
flag units
PE
[rJ"
E"
$Wb Method Analyzl
By Notes
Total Suspended Solids ^ 44
mo
667
L7
17
6LO7002 $M 2540D.1997 12/07115 09:40
MPllt
Classical Chemistry Parameters
Analyte„fCA5 Numberl Resulrs
Flag Units
2f
a"
I11.�.L
Batch Mettl grijklyyJW
By Notes
Oil & Grease (HEM-SGT) Non -Polar 28.6
mglL
1.37
VI)
5-00
6LO700.1 EPA 16&IA 12108/16 17:51
SMA
Description: Outfall 2 Lab Sample ID: CZ17821-02 Received: 12/05/16 09:30
Matrix: Surface Water Sampled: 11/30116 18:30 work Order: C.217821
Project: GDS-Cleveland Sampled Sy:]eremy Kellam
(Classical Chemistry Parameters
' - £ACO ran' CF-rtl!ierJ arvA:r fW 5911
Analyte fCAS EJUalberl Results flag Units QF M21 Pal §MSh Methcxi Analyzed fly Note@
Total Suspended Solids^ 24 mgll. I :0 !0 6L07003 Shl 2590U-1991 12107IIG 13:00 MMR
Classical Chemistry Parameters
- - -- -- :II�IIn III�w�F�lllM il��llli ---.- C'4'6ki1R3:ill
Analyte 1CAS Numberl
Oil & Grease (HEM-SGT) Non -Polar
Material
Results am VM15 12E MPL e41 Batch Method 911illyz By Notes
7.61 mg/l. 2.12 2,70 5.00 GLO7004 rPA IRAA !210HI16 17:51 SMA
r
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QUALITY CONTROL DATA
Classical Chemistry Parameters - Quality Control
Batch 6LO7002 - NO PREP
Blank (61.07002-BLKI) Prepared & Anaiyzed: 12/07/2016 09:40
Spike Source 0/6REC RPO
Analyte Result Rao ROL Units tevel Result %REC Limits RPD Limit Notes
Total Sug)endtd Sands 7.5 U 7.S mq/L
LCS (6L07002-SS1) Prepared & Analyzed: 12/07/2016 09:40
Spike Source %REC
RPD
AnDltite
Rmult Flao
ROL
Units
Level Resul[ °IaREC Limits RPD
Li01A Noses
TON11 Susfwvled Sulids
96
2.5
rn 1t
too 98 80-120
OupliLste (6LO7002-DUP1)
Prepared & Analyzes: 121071201609:•i4Y
Source: CZ1635s-o1
Spike Source %REC
RPD
Analyte
Result Flan
ROL
Units
Level ResYl %REC L103).RPO
Limit Notes
Total StlswrxiLd SoMs
3100
831)
MKlll
3500 L7
7u
Duplicate (6LO7002-DUP2)
Prepared & Analyzed: 12/07/7016 09:40
Source:CZ16870.01
Analyte
Total Suspended So4ids
Batch 6LO7003 - NO PREP
Result Flaa ROL
280
100
Spike Source %REC RPD
Units Level Result %REC Limits RPD Lima Notes
rugs 280 0 20
Blank (6L07003-ELKS) Prepared & Analyzed: M07120I6 13:00
Spike Source %REC RPD
AnalytC Result Flan ROL Units Level Result %REC Lirnl RPD Lima Notes
I N;sI SusPnndrd Snhds
tCS (61.07003-BSl) Prepared & Analyzed: 1210717016 13:00
Spike Source D/aREC
RPD
Analyte
Result Flaa
ROL
Units
Level Result %REC LinTh
RPD
IWIA Notes
.Total Suspended Sdiris
100
?, tl
my/L
100 100 60-120
Duplicate (61.07003-DUPI)
Prepared & Analyzed', QN82016 1100
Sourte:CZ07886-01
Spike Source %REC
RPD
Analyte
Result Flau
ROL
Units
Level Result %REC Limits
RPD
Limit Notes
total SuspL-�ndecl Mlids
110
33
mglL
110
0
20
Duplicate (6L07003•OUP2)
Prepared & Analyzed', 12107/2016 13:00
Source: C216267.0I
Spike Source %REC
RPD
Analyte
Result flap
ROL
Units
Level Result °/.REC L)gijb
RPD
LiEnji Notes
lulal Suspended StMs
-150
71
MR&
310
17
?.0
Classical Chemistry Parameters - Quality Control
Batch 6LO7004 - EPA 16640
Wank (61.07004-SLK3)
Prepared: 1210712DI6 11:31 Arta?yzcd: I?108/2016 17:51
Spike Source 0/aREC RPD
AnAIM Result Flau ROL Units Level 132suli D&REC i( silts RPD Limit Notes
()II & Greast} (iIFM•SGrI Nnlrirolar MM4!n;tI 2,70 LI 5.00 m01L
r IN.1 :N, r1:tx� wWtps ortly to the ry}f1t1tM: "rmaYm Dv VM Iawntory. Arid mov r>t`1v oe rtVro,11KL'a -:1 TUII I Page 5 of 8
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QUALITY CONTROL DATA
Classical Chemistry Parameters - Quality Control
Batch 6LO7004 - EPA 1664E - Continued
LCS (6L07004-GS1) Prepare0: t210712016 11:31 nnnlyrutl; 1210131201617;51
Spike Source %REC RPD
,Analyte Result Flao POL Units Level Result %REC Limits RPD Limit Notes
Oil & Grease (I16P1,SCT) Non - Polar Material 68.5 510U mg/l, 18,7 87 64-132
LCSDup(6L07004.8SD1) Prepared: 121071201611;31 Analy7Pd: 12/081201617:51
Spike
Source
%REC
RPD
AnalM
Result Fiao
POL
Units
Level
Result
%REC
Lirnit% RPD
Limit Notes
Oil & Grease (13E61•SGT) Nta'-Polar malerial
81.2
5.00
rngh
ii3.0
107
64.112 17
3•i
Matrix Spike (611.07004-161S1)
Prepared: 1210712016 11:31 Analymd: 12/08/2016 17:53
Source: 8ZOS 272-01
Spike
Source
%REC
RPD
Analyte
Result Flaq
POL
Units
Level
Result
%REC
Limits RPD
Limit Notes
Od & facaw (10M.S(Tf) Non-Potar MaterW
105
5.00
mgJL
9:1.3
9Ti)
9
o-7 1J?
QM-07
FIMAI. s tiis,er v: P�31M Only 0) the- �IOVII ns IKI. la 0v use IaOG'IIM, and mar ON. n4 remwx,0 in 1:::i I Page 6 of 8
= CE;'-.P')
eN ;� Q
www.encolabs.com
FLAGS/NOTES AND DEFiNMONS
B The analyze was detected in the associated method blank.
n The sampfe was analyzed at dilution.
J The reported value is between the laboratory method detection limit (MDQ and the laboratory method
reporting limit (MRL), adjusted for actual sample preparation data and moisture content, where applicable.
U The analyte was analyzed for but not detected to the Level shown, adjusted For actual sample preparation
data and moisture content, where applicable.
E The concentration indicated for this analyte is an estimated vatue above the calibration range of the
instrument. This value is considered an estimate.
MRL Method Reporting Limit. The MRL is roughly equivalent to the practical quantitation limit (PQL) and is
based on the low point of the calibration curve, when applicable, sample preparation factor, dilution
factor, and, in the case of soil samples, moisture content.
N The analysis indicates the presence of an analyte for which there is presumptive evidence (85% or greater
confidence) to make a "tentative identification
P Greater than 25% concentration difference was observed between the primary and secondary GC column.
The lower concentration is reported.
QM-07 The spike recovery was outside acceptance limits for the MS and/or MSD. The batch was
accepted based on acceptable LCS recovery.
FINAL TIIIS rl!� I ItMtC —W W tbc"3mpC -; -- • by U t; Iar I—), old, ae rL' Oam('6 KI !ICI I Page 7 of S
Cf.,!
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le#b;' Standard
Expediled
Ixr 141,, Due
b War ler
'SA
I 'tj
Nlv:.' Tall r c'
S..," ID IFql Un-, Sample Comments
Outfail. X
OUT- TA
a
7 —7_
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otal o of Containers
Ll1w. By 7 D T
By'
Gvrccenr
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NOIn Ar sj'-:Atra to FNC.(' 2,p � ,xC,jr.Rk •ll� to.—. tpr --S 1 .7 wIlIn 3O'Q'l-w'13 e-IA
r
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water QL4ality General Permit No. NCG080000
Date submitted 7 / f45
CERTIFICATE OF COVERAGE NO. NCG08 O 2 1 O SAMPLE COLLECTION YEAR 2016
FACILITY NAME RIWPu BLto, <3rPytCE; — G.65 Alm;4NIVAI SAMPLE PERIOD Q Jan -June ❑ July -Dec
COUNTY LkR or ❑ Monthly' _ (month)
PERSON COLLECTING SAMPLES WAt>jE GoosSEW,5 DISCHARGING TO CLASS ❑ORW '❑HQW ❑Trout ❑PNA
LABORATORY L / 1dA LL Lab Cert. f# 3771Z , ""d ❑Zero -flow [ ater Supply ❑SA
ECEIVC
Comments on sample collection or analysis. - D ❑Other
Part A. Vehicle Maintenance Areas Monitoring Requirements
JUL 19 2016
CENTRAL FILES
DWR SECTION
PLEASE REMEMBER TO SIGN ON THE REVERSE -)
❑ No discharge this period'
OutfaN.
No.
Date
Sample Collected,
: mo/dd% r
00530. :.
00400
00556
Ttital'Susperided
Sollds;.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
Benchniirk
-
50 or:100 see oerinlf `
.. " WithI6 6.0 = 9,0 .
15
06 7
.D
7, Y6
WD
$d
06 a7 ��
. o
,
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
No.
Date:
Sample. Collected,
mti/dd/ r'.
00556
00530
00400
Non -Polar Oil and.Grease/TPH EPA:Method
1664 (SGT-HEM);,rhg/L
Total Suspended 5ollds;
mgf l :
pH,
Standard units
Permit Elmlt "
15.
50 or 100'see permit,'
6.0 = .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:
Datero--27-/6 (first event sampled)
1 �s
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 Z or Tier 3 responses. See General Permit text.
FOR PART A AND PART B M NIT RING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER ATTHE 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:
!l an original nd one covy of thisDMR including all "No Discharge" reports, within 30 days of receipt h ab results tgr qt end of monitoring eriod in
the case of "No Discharge" regQrWo:
Division of Water Quality
Attn: DWQCentraI F11es
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFIQTIONFOR iShly INEORMAJION 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
7 /'9 r/�
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wglws/su/npdessw#tab-4
SWU-250
last revised October 25, 2012
Page 2 of 2
Semi-annual Stormwater Discharae Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted 12 - 9 _/ S-
CERTIFICATE OF COVERAGE NO. NCGO8 O z i O SAMPLE COLLECTION YEAR 2 D 1 5 100
FACILITY NAME FrE PLk LI C . G-4.VrdA1 SAMPLE PERIOD ❑ Jan -Junes &July-Dec04'.
COUNTY or Monthly fmanthl
;�p
PERSON COLLECTING SAMPLES RECEI V B HARGING TO CLASS ❑ORW QHQW []Trout ❑PNA
LABORATORY E PAIA L rl e A L Lab Cert. # []Zero -flow [Water Supply QSA
Comments on sample collection or analysis: qi2 DEC 1 U �U i5 ❑Other
CENTRAL FILEPLEASE REMEMBER TO SIGN ON THE REVERSE 4
DWR SECTIONTION
Part A: Vehicle Maintenance Areas Monitoring Requirements ❑ No discharge this period'
'�.Outfall •. ,��
No .: -..',`
,• _ .;::,. f;
� �. Date :
: Sarripfe;Callected, :
` .: ma dd` `i' ::...
dD5$0:....
- �. �00400 `
. OOS56 � .
� . .
-.':'>+otai`•S i l` ed
aollds;.iri
pH ::: ' .
= Standard bolts
::Non=Polar. Oil andGrease/TPH-EPA -,
° Method 1664 SGT=kiEM ;.tn L ." .
kiVi,Mbtor:bil�Us'ege,
Agnusi:avera 1%rtno .'
Ier3hMark .
.::'..•::,-
SO or:100'see ernilt
: :.Wlt�ilii 6.0 9.0 ...
.:_:: ..; .aS .• ..:.:.
,. ..,.:.
Z
I1-30—i5'e
7,
a
0
- 30 - S
. 0
7,
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
Date: A0656: .. _ 00530. 00400
t No :Sample Callected, Non -Polar Oil a1ndLGOea se/TPH EPA:Mkhod: Total Suxpendad Sallds, . pH,
mo/dd r : 16$4 (SCaT�HSM): L rti L :_ StandaM units
Permit Lliit�it ` iS - '50 far 100'sti4vermlt:. b.0 - 9' .
t For sampling periods wlth no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised Octobcr 25, 2012
Pagel of 2
STORM EVENT CHARACTERISTICS:
Date It •30-15 (first event sampled)
Total Event Precipitation (inches): 3. y9
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: if you report a sample value in excess of the benchmark, you must Implement Tier 1, Per 2, or Tier 3 responses. See General Permit text.
FOR P6RJ IAA, D PART B MONljQRIN!Q BESULD:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART It SECTION B.
2 EXCEEDANCES iN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an orlainal and one -my ef this 2M& lndulfiM all No- 0-hrhowe rwaiu within 30 days of recelpt afft lab remits & at end of mgnitorlhajoerlod I
the case of "No Dlscharae" ryyaUl to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
XQU Ml13T5I9N THI$CERTIFICATION FOR ANYINFORMATIQNREPORTED:
"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 signlficgnt penaftles for submitting false Information, including the possibility of fines and Imprisonment for knowing violations."
(Signature of
/ - /S
(Date)
Additional copies of this form may be downloaded at: http.11porta.l.ncdenr.org/wgbIwaLws/su/npdessw#tab-4
SWU-250
last revised October 25, 2012
Paste 2 of 2
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted
_ .. SAMPLE COLLECTION YEAR
CERTIFICATE OF COVERAGE NO. NCGO8 0 Z O
FACILITY NAME�EP(XfktC �rkULCES (SbS /77 aN SAMPLE PERIOD [7/�Jan-June ❑July -Dec
COUNTY Z to K 1Z or ❑ Monthly' (month'
PERSON COLLECTING SAMPLES ' vOsS" S —`DISCHARGING TO -CLASS ❑ORW--❑HQW—❑Trout'CgPhtA ----- - -
LABORATORY FACE ANAtyr,CA L Lab Cert. # 3212 Z/0 RECEI v ED ❑Zero -flow �ater Supply �RSA
Comments on sample collection or analysis: ❑Other
a : z�s--2 OCT 0 9 Z015
339 TILES PLEASE REMEMBER TO SIGN ON THE REVERSE
CENTRAL
Part A: Vehicle Maintenance Areas Monitoring Requirements DWR SECTION
❑ No discharge this period'
butfall .
Date
00530
00400
00556
No
Sample Collecteii;
Total Suspended
pH,';;
:Non,iP0 .r Oil and Grease/TPH EPA :;
New Motor Oil''sage,.
a
mo/dd/yr.'
Solitls, mg/L''
Standard units .
° Method- -HEM) liig/L
k ;Annual average gal/mo.,'.
BenchmarkS0or100
see: ermrf
'WitNiri6:0 9 0 _
_ 15
.2
os z S
e1
� 02
D
RO
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': ;. Date::_ '0055v, 00530;° 00400
No Sample Collettei, 'Non'Rolar Oil and GreaseI7PH EPA°.Method Total Suspended Solids: ;pH,
.,
_ mo/dd/yr:, ' 1664 (SGT=HEMj,f`mg/L :mg/L =Standard units. .
Permit.Linli# 15 50or:100 see permit; 6A.. 90
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
r
STOR&I EVENT CHARACTERISTICS:
Date SIZ (first event sampled) /1
Total Event Precipitation (inches): J - to
Date AIA (list each additional eventsampled this reporting period, and rainfall amount)
Total Event Precipitation (inches): e!1
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 ATTHE 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 copv of this DMR. includina all "No Discharae" reports, within 30 days of receipt of the lob results (or at end of monitoring 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. 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)
S- 30 l�
(Date)
Additional copies of this form may be downloaded at: htti)://portal.ncdenr.org/webZwq/ws/su/npdessw#tab-4
SWU-250 last revised October 25, 2012
Page 2 of 2
._*0
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted
CERTIFICATE OF COVERAGE NO. N0008 0 Z O�
FACILITY NAME MIR 6LIL-j&LGES "
COUNTY Z t4 R_K_E
LABORATORY +'A cE 8NA[jT e—A L- Lab Cert. #1 -?U1;2 a
Comments on sample collection or analysis:
M19cr WO. 9z25-2339
Part A; Vehicle Maintenance Areas Monitoring Requirements
SAMPLE COLLECTION YEAR 2 O
SAMPLE PERIOD [Jan -June ❑ July -Dec 0,6
or ❑ Monthly' Lmonthl
DISCHARGING TO-CLASS`[]ORW`❑HQW ❑Trout ❑PNA
❑Zero -flow 9water Supply ❑SA
RECEIVED ❑Other
JUN 2 2 20i5 PLEASE REMEMBER TO SIGN ON THE REVERSE -)
CENTRAL EKES ❑ No discharge this period'
DWR SECTION
Outfall
No: ' '.
Date-' :
Sample,Cullected,
t mo/dd% r'.
: 00530 �, .
.00400 `
00556 ..
Total Susp'tirided
-; r. ,
:Solids; mg/L
pH,
Standard units
'Polar 011 aid Grease/TPH EPA _
Method 1664'(SGT-HEM), mg%L-
New Motor:0il linage,
--Annual average`gal/mo
'Bencfiri'ark`'
'.,.
50'or-100see errriit'
. 'Within6.0=9.0 :
15
-
1
os z S47..1
Kb
aS 2 S
d Q
, 141D
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
ouutfall
No.
Dater
Sample Collected,
mo/dd/ r
00556
00530 . .
00400
� Non -Polar Dll arid,Giease/1 PH EPAMethod
1664•(SGT=HEM);°mg/L
Total Suspended Solids,
.. mg/L., :
pH,
Standard units
Permit Llinit -
is '
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.
SWIJ-250 last revised October 25, 2012
. Page 1 of
STORM EVENT CHARACTERISTICS:
Date -524//5 (first event sampled)
Total Event Precipitation (inches): 5-
Date 11A (list each additional eventfaampled this reporting period, and rainfall amount)
Total Event (Precipitation (inches): AIA
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 MQNITQRING 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 4OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO a
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mall an original and one coon of this DMR, includina all "No Dischorae" reports. within 30 dons of receipt of the lab results for at end of moni;4rina 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. 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)
(Date)
Additional copies of this form may be downloaded at: http:l/Portal.ncdenr.org/web/wq/ws/sulnpdessw#tab-4
S WU-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 SAMPLE COLLECTION YEAR Z O 1 3
FACILiYM1AME �pLiLGf �TSAMPLE PERIOD rjan-June%iuiy-Dec
COUNTY 'BI R K or []Monthly (month)
PERSON COLLECTING SAMPLES AD E G�GbS5DISCHARGING TO CLASS iL]ORW ❑HQW W ! )Trout ❑PNA
c/5_ -
LABORATORY E:d(f 0 — Lab Cert. is ❑Zero -flow ®Water Supply ❑SA
Comments on sample collection or analysis: RECEI [:]Other
�L) PLEASE REMEMBER TO SIGN ON THE REVERSE 4
JUN 0 3 Z014
Part A. Vehicle Maintenance Areas Monitoring Requirements CENT ❑ No discharge this period'
DWQ/S FILES
= + putfall Data 00530 -: 00400 '`..00556 _
x No. Sample Collectiecf, ; Tatal Suspended pH, Nnn Polar;011 and Grease%TPNEPA New Motar,0il Usage,
. .. mo/dd/ r,: ;Sallds,:mg/l. Standard uniu.,. :Method 1664 {SGT-HEMS, mg7i:.: . Ahnuat average gal/iiso
Beatitih'mark SQo�`100see'iiermlt< `Within`6.0-9.0'::: _ 5.
I Z I S/Is/ 15t 1 5: r. n 1 rQ. R2 I ;R. 64 1 NO I
. SO
Did this facility perform Vehicle Maintenance Activities using more than SS 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
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-?gp last revised October ?S, 2012
Page I of 2
4
STORM EVENT CHARACTERISTICS:
Rate � 5" / (first event sampled)
Total Event Precipitation (inches): 0 , 7s
Date (list each additional event sampled this reporting period. and rainfall amount)
Total Event Precipitation (inches): ^4A -
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 ANO PART B MONITORING, RESULTS:
• A BENCHMARK EKCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART 11 SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER ATTHE 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 ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO
REG,'C,'.. OFFICE C-0NTAIT NAME:
M it an on lnal and one COPV of this DMR including all "No Discharge" reports, within 30 days o recei t o the lab results or at end of monitoring period In
the case of "No Dfscharae" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mai! Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REP RTER:
"I certify, under penalty of law, that this dOCUMP'nt 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 impr i<_ortrrent tar knowing v. c!ations."
ISlgnature of Permittee)
Z-
(Date)
Additional copies of this form may be downloaded at: htt2:.1jop rtai ncdenr.or weh[vr / vs/su//npdess,.v#tab-4
S W U-250
last revised October 25, 2012
Page 2 of 2