HomeMy WebLinkAboutNCG080787_MONITORING INFO_20190103PERMIT NO.
DOC TYPE
STORMWATER DIVISION CODING SHEET
NCG PERMITS
/v (.C,080gm
n HISTORICAL FILE
U MONITORING REPORTS
DOC DATE I I C/)i�19CJ I U�
YYYYMMDD
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No NCG080000
Date submitted 12/11/2018
CERTIFICATE OF COVERAGE NO N0008 0787
FACILITY NAME Republic Services / GDS Davie
COUNTY Davie
PERSON COLLECTING SAMPLES John Isenhour
LABORATORY NA Lab Cert #
Comments on sample collection or analysis
RECEIVED
2018
ED SAMPLE PERIOD ❑ Jan -June ® July -Dec
JAN 0 3 2019 or ❑ Monthly' _ (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
CENTRAL FILES ❑Zero -flow ❑Water Supply ❑SA
DOER SECTIOtI ❑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?
(if yes, report your analytical results in the table immediately below)
Part A Vehicle Maintenance Areas Monitoring Requirements (If applicable)
yes x no
® No discharge this period'
Outfal I
No
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total -Suspended
Solidi; mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664`(5GT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 6 0 — 9 0
15
-
Outfall 1
30 gal/mo
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 I, 2013
Page I of 2
STORM EVENT CHARACTERISTICS
Date 12/11/2018 (first event sampled)
Total Event Precipitation (inches) 0 24
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 11 SECTION B
• TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mal an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at e»d 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 signifssZFZ-aenaWes for submitting false information, including the possibility of fines and imprisonment for knowing violations '
(Signature of Permittee)
PlAs
(Date)
Additional copies of this form may be downloaded at http //portal ncdenr o,re/web/wq/ws/su/npdessw#tab-4
SWU-250
last revised April 11, 2013
Page 2 of 2
IV -t
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No NCGO80000
Date submitted 07/31/2018
CERTIFICATE OF COVERAGE NO NCG080787
FACILITY NAME Republic Services / GDS Davie
COUNTY Davie
PERSON COLLECTING SAMPLES John Isenhour
LABORATORY NA Lab Cert #
Comments on sample collection or analysis
SAMPLE COLLECTION YEAR 2018
RE C �--� V'"" � � SAMPLE PERIOD ® Jan -June ❑ July -Dec
AUG 0 9 ?W- or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
CENTlRf'„ F11 " ❑Zero -flow Water Supply [:]SAD�rIR SI-:.G`i I )- ❑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 months 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'
�utfallk x
Not
- _
D tex,
5 pie Collected,
mo/dd/,yr
00530
iota) SuspendedENtandWard
Solids, mg/,L
xiu* r 00400
Munits
xx W=�� 005y
Non-Polar OBI and Grease/TPH EPA
Method 1664,(SGT:HEM_ ), mg/,L
New Moto�ai
AnnuaIS
1BenChmark
. , ,v,
50Ao_r i00 see permit
Within 6 0. ! 0 ..;..
_g;,
-
1
NA
PartB Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
a;g0 tfa Ilw�
No
` _ rw
Sample Coll�ed;z
�#iiio/.dd/,yr
MNN Polar Od and Grease/TP.H EPA Method
1fi6_4 (SGT;IiEM), mg/,L :,,
_* Taia'ItSuspended Sohds,
mg/,L
�;� ,�- pH, `T'� '
h .r 5tandard units -I
Permit Limi
-
15;,�?�
501or 100 see permit
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 oft
t --
STORM EVENT CHARACTERISTICS
Date 06/26/2018 (first event sampled)
Total Event Precipitation (inches) 0
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches)
Note if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
FOR PART A AND PART B MONITORING RESULTS
• A BENCHMARK EXCEEDANCE TRIGGERS TIER I REQUIREMENTS SEE PERMIT PART It SECTION 8
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS SEE PERMIT PART 11 SECTION B
• TIER 3 HAS YOUR FACILITY HAD 4 DR 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 otthis AMR, including all "No Discharge" reports, within 30 days of receipt of lab results or at end of_monitorina period in
the case o "No Dischar e" reports) to
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699 1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personnel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system or those persons
directly responsible for gathering the information, the information submitted is to the best of my knowledge and belief, true, accurate and complete I am aware that
there are significant penalties for submitting false information including the possibility of fines and imprisonment for knowing violations
(Signature of Penmittee)
Additional copies of this form may be downloaded at http //portal ncdenr org/web/wq/ws/su/npdessw#tab-4
SWU 250
last re% Esed April 11 20133
Page 2 of 2
a
• Semi-annual Stormwater Discharge_ Monitoring Report
for North Carolina Division of Water Quality General Permit No NCGO80000
Date submitted /11 /ova
CERTIFICATE OF COVERAGE NO NCG08 0787 RECEIVED SAMPLE COLLECTION YEAR 2017
FACILITY NAME Republic Services GDS Davie
AR 0 12018
COUNTY Davie
PERSON COLLECTING SAMPLES David Gauntt CENTRAL FILES
LABORATORY NA Lab Cert #t DWR SECTION
Comments on sample collection or analysis
SAMPLE PERIOD ❑Jan -June ® July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow Dwater Supply [_]SA
❑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? _ yes x no
(if yes, report your analytical results in the table immediately below)
Part A Vehicle Maintenance Areas Monitoring Requirements (If applicable)
M 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
-
ca
30 175
Part B Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Out -fall
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
Page 1 of 2
StORM EVENT CHARACTERISTICS
Date 12/09/2017 (first event sampled)
Total Event Precipitation (inches) 0 53
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches)
Note if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier Z, or Tier 3 responses See General Permit text
FOR PART A AND PART B MONITORING RESULTS
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS SEE PERMIT PART II SECTION B
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS SEE PERMIT PART II SECTION B
• TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Marl 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)
a I/I//a6►g
(Date)
Additional copies of this form may be downloaded at http //portal ncdenr org/web/wci/ws/su/npdessw#tab-4
S WU-250
last revised April 1 1 2013
Page 2 of 2
A
Semi-annual Stormwater Discharge Monitoring Reort
for North Carolina Division of Water Qua ity General Permit No NCG080000
Date submitted G S 1
CERTIFICATE OF COVERAGE NO NCG08 G ] _& _Z
FACILITY NAME „I� ��/1 c 5.��.c=s f G NL Gbs
COUNTY aju 6-
,
PERSON COLLECTING SAMPLES,
LABORATORY C &'L(-,) Lab Cert 4 AIC IYI/2
Comments on sample collection or analysis
Part A Vehicle Maintenance Areas Monitoring Requirements
SAMPLE COLLECTION YEAR D I
SAMPLE PERIOD Q Jan -June ❑ luly-Dec
r=IV�F y) or ❑ Monthly' month
DFS if RGING TO CLASS ❑ORW ❑HOW []Trout ❑PNA
JUL 31 zou ❑Zero -flow ❑WaterSuppiy ❑SA
❑Other
CENTRAL FILES
DWR SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE -i
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/TFH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gaVmo
Benchmark
-
50 or 100 see permit
Within 6 0 — 9 0
1s
-
1'
c>sa ds Lu�-i
— J
z �a
zsv
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?/C yes _no
(if yes, report your analytical results in the table immediately below)
PartB 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
3s
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
SW U-250
fast revised October 25, 2012
Page i of 2
.'Ap
STORM EVENT CHARACTERISTICS
Date ra 5 ! 7 (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 Trer 3 responses See Genera! 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 I! SECTION B
• TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE" YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mail an original and one con V of this DMR includin all ' No Dischar e" re its within 30 da s o recer t a he lab results or at end o monitoringperiod in
the case of "No Discharge- rggortsl to
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center
Raleigh North Carolina 27699 1617
YOU MUST SIGN THIS CERTIFICATION rOR 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 f e information including the possibility of fines and imprisonment for knowing violations'
(Signature of Permi tee) (DAe—)
Additional copies of this form may be downloaded at http /lportal ncdenr oWweb/wq/ws/su/nydessw#itab 4
SWU 250
last re,. ised October 25 2012
Page 2 of 2
Semi-annual Stormwater Discharge Monitorinjg Report
for North Carolina Division of Water Quality General Permit No NCGO80000
Date submitted
CERTIFICATE OF C VERA, E NO NCGo8
FACILITY N E , b� >v ,�• ►G
COUNTY _1 s t✓
PERSON COLLECTING SAMPLES v
LABORATORY_ _� NCO Lab Cert # G
Comments on sample collection or analysis
Part A Vehicle Maintenance Areas Monitoring Requirements
SAMPLE COLLECTION YEAR
SAMPLE PERIOD ❑ Jan -June aJuly-Dec
—. ,--or--[] Monthlyi_..--�(montpj- —
AR CLASS [ORW~[HQW [Trout ❑PNA
E ❑Zero -flow ❑Water Supply ❑SA
JAN 1 1 2017 ❑other
CENTRAL FILO LEASE REMEMBER TO SIGN ON THE REVERSE 4
DWR SECTION ❑ No discharge this period'
outtail
No
Date
Sample Collected,
mo dd/ r
00530
00400
00556
Total Suspended
Solids, m#L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 SGT-HEM), m L
New Motor Oil usage,
Annual average gal/mo
Benchmark
SO or 100 see permit
Within 6 0-9 0
1S
a /�0
i
-.a •
a so
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)
PartB ail/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals
outtail
No
Date
Sample Collected,
mo/ddj r
OOSS6
00530
00400
Non -Polar ail and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
1s
50 or 100 see permit
6 0 - 9 0
For sampling periods with no discharge at any single outfail, you must still submit this discharge monitoring report with a checkmark here
$WU-250 last revised October 25,201,2
Page 1 nr2
STORM EVENT CHARACTERISTICS
Date 10�' 6-A(flrst event sampled-l�-
Total Event Precipitation cinches)
Date (list each additional event sampled this reporting period, and rainfall arnountj
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 8 MONITORING RESULTS_
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS SEE PERMIT PART o SECTION B
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS SEE PERMIT PART 11 SECTION 8
• TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL7 YES[JN071
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ Nd D
REGIONAL OFFICE CONTACT NAME
orlaltlal and one my of this DlMR. including all ".(W Discharr" aggrts sib n 10 gays of rf�eiyt of the tab sWts for at end of martt10ring Mrfod t
Me WK of ti Dlscharr�e" ret� t ro
Division of Water Quality
Attn DWQ Central Files
1617 Marl Service Center
Raleigh, North Carolina 27699 1617
YOU MUST SIGN THI 5 CERTIFICATION FOR AINY lNFORM8jJ0N,REP0RjLj?.
'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 j&Ajficant penalties for Sub1yV false Information, including the possibility of fines and imprisonment for knowing violations "
M
(Signature of Permittee)
ar10510;
( Date)
Additional copies of this form may be downloaded at httpjj�ortal rudenf or,&/web w ws su n desSwgtab 4
SWU 250
irrtii rcvi%Ld Otusbcr 25 20121
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No NCG080000 Cr::
Date submitted ��nn
CERTIFICATE OF CoxER GE No N GOS 0 Z MPL€ COLLECTION YEAR _ 1 `0/
FACILITY NAME t� 714 c v ✓ ►� �`�rl V e `aRMPLE PERIOD Jan -June ❑ Juiy-Gec n-
orCOUNTY Lc, ]) %/� �q,�j ❑ Monthly' _ (maoth)
PERSON COLLECTING SAMPLES G G U� L — SUN O DISCHARGING TO CLASS ❑ORW ❑HQW []Trout 01>40
LABORATORY LA Cert q C �>r1�E5 ❑Zero -flow ❑Water Supply ❑SA�v
Comments on sample collection or analysis C WR C��ON ❑0ther /}
p v~C
Part A Vehicle Maintenance Areas Monitoring Requirements
PLEASE REMEMBER TO SIGN ON THE REVERSE --)
No dischorge this period'
Outfall
No
Date
Sample Collected,
mo/dd/ r
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
is
-
3
L-7
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 Balk 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
i For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here
S W U-250
last revised October 15. 2012
Page I of 2
STORM EVENT CHARACTERISTICS
•. r Date' ° {first event sampled) J
Total Event Precipitation (inches) 1 i
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 11 SECTIONS
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS SEE PERMIT PART 11 SECTION B
• TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME
Marl an orfainal and one copy of this DMR, includinq aff "No DisqrpNa s regb�so-for at end of mon►tortna period In
the case of "Na Digharcle" r,_,ports) to
Division of Water Quality
Attn DWQ Central Files
1617 Marl 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 ayg significant penalties for submitting false information including the possibiiity of fines and imprisonment for knowing violations
of
547/1
{Date)
Additional copies of this form may be downloaded at htto 1 f portal ncdenr org/webZwq/ws/su/ripd.esswqtab a
SWU 250
Iasi 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 G ERA E o pNpC�G 8 0 7� j
FACILITY NAME � �G Wa �
COUNTY +tJ+TJ1C. _0 1
PERSON COLLECT NG SAMPLES K dtfC
LABORATORY_ NCO L bCert # l
Comments on sample collection or analysis
Part A Vehicle Maintenance Areas Monitoring Requirements
REej!i v EE)
NOV302015
CENTRAL PILES
DWR SEC7-1c)N,
SAMPLE COLLECTION YEAR
SAMPLE PERIOD ❑ )an -,tune luiy-Dec
or ❑ Monthly' _ (month)
DISCHARGING TO CLASS [JORW []HQW ]Trout OPNA
[]Zero -flow ❑Water Supply []SA
[]Other
PLEASE REMFMBER TO SIGN ON THE REVERSC -->
No discharge this period'
Outfall
No
Date
Sample Collected,
mo/dd/ r
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/rno
Benchmark
50 or 100 see permit
Within 6 0 - 9 0
is
-
a
L - -7
0
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes _no
of 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
i For sampling periods with no discharge at any single outfall you must still submit this discharge monitoring report with a checkmark here
SW U 250 Iasi revised October 25, 2012
Page I of 2
rim
. STCrRM EVENT CHARACTERISTICS
Date 2-1-)4 (first event sampled) f
Total Event Precipitation (inches)
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches)
Note if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tter3 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 Il SECTIONS
• TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFAI.L7 YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME
Marla i lnal and one copy oLtins DMR including all "No Discharge" re orts within 30 days of receipt of he lob results Lor at gnd of moriltorFrijq per#94n
the -case of "No Dischar-ae"rgportsl t2
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699 1.617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION RtPORTED_
"I certify under penalty of law that this document and all attachments were prepared under my direEt+on or supervision in accordance with a system designed to assure
that qualified personnel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system or those persons
directly responsible for gat enng 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 pen t es 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 t�tj)jjportii icdem of web w ws su ii pdessw► l:ab 4
SWU 250 last revised Oetnbei 25 2012
Page 2 of 2
r A
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quahty General Permit No NCG080000
e,&
Date submitted
CERTIFICATE OF COV RAG No NCG 8 4 Z�"7 SAMPLE COLLECTION YEAR
FACILITY NA E Jna { SAMPLE PERIOD K Jan -June ❑ July -Dec
COUNTY �vy nn or ❑ Monthly'(month)
PERSON COLLECT G SAMPLES ��cEIvSLRiSCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY & /V 60 Lab ert # G 2 13 Flzero flow ❑Water Supply ❑SA
Comments on sample collection or analysis M��
GE R GT 4� PLEASE REMEMBER TO SIGN ON THE REVERSE
Part A Vehicle Maintenance Areas Monitoring Requirements ❑ No drschorge this period'
Qutfall
NO
Date
Sample Collected,
,rtta/dd/yr
00530
00400
00556
Total Suspended
Solids, mSIL
` 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 100Jsee permit
Within 6 0 — 9 0
1s
-
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)
PartB Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals
ootfall
No,
`Date
Sample Collected,
r`no/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 Umit
2
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
SWO 250 last revised October 25 2012
Page 1 of 2
STORM} EVENT C1 ARACTERISTICS
Date 3`17 I rifirst event sampled)
Total Event Precipitation (inches) _
Date (list each additional event sampled this reporting penod, 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 8
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS SEE PERMIT PART 11 SECTION B
• TIER 3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCE£DENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL-) YES Q NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE' YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mail an orJainal and one o this DMR rncludin all "No Dischar e" re orts within 30 da r re1 t o the I b results or at end monrtann ertad n
the Me of "No Dlscharae" reports} to
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699 1617
YOU MUST SIGN THIS CERTIFICATI N FOR ANY INFORMATION REPORTED
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 respons¢ble for athenng 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 p ria t es for submitting false information including the possibihty of fines and imprisonment for knowing violations "
(Signature of Permittee
5- f
(Date)
Additional copies of this farm may be downloaded at hit octal ncdenr orR/web/wg/wslsu/twdessw4tab 4
SWU 250
last revised October 25 2012
Page 2 of 2
Semi-annual Stormwater„Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No NCG080000
Date submitted
CERTIFICATE OF C$VERAG��NO NC 08 -7 �
FACILITY NAME r `tom - "64191 Cw1 e,lc_ ([lotw u)
COUNTY Q te, %
PERSON COLLECTI G SAMPLES as/
LABORATORY WN U —Yab Cert g IVClqq3z.
Comments on sample collection or analysis
Part A Vehicle Maintenance Areas Monitoring Requirements
SAMPLE COLLECTION YEAR c ,0141
SAMPLE PERIOD ❑ Jan -June Z July -Dec
or ❑ Monthly` (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow []Water Supply []SA
RECEIVED ❑Other_- - —
NOV 19 2014 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL. FILES ❑ No discharge thJ5 period'
DWR SECTION
Outfall
No
Date
Sample Collected,
- mo/dd/yr
00530
004DO
OD556
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
-
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)
PartB Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals
Outfall
No
Date
Sample Collected,
"n dd/yr
00S56
OOS30
00400
Non•Po_lar Od and Grease/TPH EPA Method
1664 (SGT-HEM), mg%L
Total Suspended Solids,
mg((---
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 October 25, 2012
Page I of 2
STORM EVENT CHARACTERISTICS
Date l-1-M (first event sampled)
Total: Event Precipitation (Inches) _
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches)
Note if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See General Permit text
FOR PART A AND PART B MONITORING RESULTS
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS SEE PERMIT PART 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 ANYONE OUTFALL7 YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICES YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME
Mall an original and one cony of this DMR, indudlno all "NQRischame" reports, within 30 days, of recent of the lab results (or at end of monitoring period in
the cafe o I"No Drschar e" LMyj
to
Division of Water Quality
Attn DWQ Central Files
1617 Mad 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 slgnlficapt penalties for submitting false Information, mduding the possibility of fines and Imprisonment for knowing violations'
(Signature of Permittee)
tf-r7-/Y
(Date)
Additional copies of this form may be downloaded at http Z&ortal_licdenr orgLweb/wct/ws/su/npdesswgtab 4
SWU 250
last revised October 25, 2012
Page 2 of 2
0/1
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No NCG080000
Date submitted
CERTIFICATE OF COV RAG �O NCg08 O 7 � 7
FACILITY NAME _ _%0 �G �✓ �tt.1�G� (J�l � JfiG _
COUNTY
PERSON COLLECTING SAMPLES
LABORATORY_ L L G'o _ „ 6b Cert #
Comments on sample collection or analysis
Part A Vehicle Maintenance Areas Monitoring Requirements
RECEIVED
APR 2 5 ZU14
SAMPLE COLLECTION YEAR
L DWHL
krr
��% y 00A180G ES
SAMPLE PERIOD Cglan-June ❑ 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 -)
[] No discharge this period'
Outfa_ ll }
} r "'
�' Date T
,t
Sarnpie'Collected, ,
fi{ .. ' lT..' 2
r 00530_
00400 `t
- ' 00556
yNew
,, Jotal'Suspended -" ,
f 4a...F E 5" r }
•Solids, mg/L �- _
'pH, : K�
1 'E• 4 4 &3 !
Standard`unit"s, FY
Non-Polar..Oil and`Grease%iPH EPA.,
1 Jr
,Method'1664' (kT-HEM), rig/L :
Motor Oil Usage,
V 4 �r� i{ M1 N V F J
Annual average gal/mo 1
Benchmark,
errnit
Within 6 0 -- 9 0
�r _ 15
1
-1 �
5% 1
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
zo6tfall
,.'No . _ _ s
- - Date
Sarno; Collected, �i
nio/dd/yr -
+, �" `00556
100400
� Non -Polar Oil and Grease/TPHIPA Method -
Y .1664 (SGT HEM), rrig�l
- r ',Total Suspended Solids,
m/L J
� r pH,
Standard,units
Permit Limit
f f y`
- 1S =
- 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 October 25, 2012
Page I of 2
STORM EVENT CHARACTERISTICS
Date qy7 % (first event sampled)
Total Event Precipitation (inches) _ I
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches)
Note if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses See Genera! Permit team
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 OUTFALL7 YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME _
Marl an original and—o_ne copy of this DMR, including all "No Discharge" reports, within 30 days of receipt o the !ab results or aiend o monitoring aerlod in
the case of "No Discharge" re Ortsl to
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YQU 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 sigyrtficant penaltq for submitting false information, including the possibility of fines and imprisonment for knowing violations "
(Signature of Permittee)
4(- z '?, i
(Date)
Additional copies of this form may be downloaded at http Lpartaf ncdenrorg(web wg/ws/su/npdessw#tab 4
SWU-250
last revised October 25 2012
Page 2 of 2