NCG140291_MONITORING INFO_20170914

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V
DOC TYPE
❑HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ Do I 1 C) 9 �
YYYYMMDD

a
MA�
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: httRf /nortal.iicdenr,org/web/Ir/nudes-5tgrmwatCrI
Permit No.: N/'C/3 J'/�/ _a/ O/C� or Certific to of Coverage No.:
Facility Name: EB /kcj) Ca A64�Co . ,h1%tiL4
County: lZ-QuNSJnj CK Phone No. 3 -- 6S'd ~orb o
Inspector:_ /fA-Ey c-r. vk-17-2-
Date of Inspection:
Time of Inspection: .3 '0o P/Y7
Total Event Precipitation (inches): ` J ,4�—
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)�13�u+�F/�d1
ZYes ❑ No R�C',FI1/EC)
SEP 14 2017
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit). DWR SECTION
INFORKATION WC:FSAG UN7
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains app;erv(al from the local DWQ Regional Office.
By tly?ignature, I cyhjfy that this report is accurate and complete to the best of my knowledge:
nature V Permittee or Designee)
Page 1 of 2
5WU-242, Last modified 7/31/2013

.y
1. outfall Description: Qutfall No. I- Structure (Pipe, ditch, etc.) t t Al id Get�leAr of p!� °+y)
Receiving Stream:INIA D�� r�+°"Na9�df�^
Describe the industrial activities that occur within the outfall drainage area:
Sa+�d re a Sir w- A;t*S
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc,) and tint
(light, medium, dark) as descriptors: b? V� B(%&*^
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oi.l,
weak chlorine odor, etc.): /4owe
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and S is very cloudy:
® "2 3 4 a
S. Floating Solids, Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1Q 2 3 4 .5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
0 2 3 4 5
7. is there any foam in the stormwater discharge? Yes
8. is there an oil sheen in the stormwater discharge? Yes
9. is there evidence of erosion or deposition at the. outfall? Yes
10. Other Obvious indicators of Stormwater Pollution:
List and describe No1s—,
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
maybe indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, last modified 7/31/2033

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR)— STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year &/ 7
"Report ALL STORMWATER monitoring data on this form (include "No Flow"/"No Discharge" and Benchmark
Fxceedanees) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No, NCIS142121B 0
Facility Name: _ A _ v9°__Slnal�-
County: r3,r%>v13 r'-K _
Phone Number` S S-o —.2 OD Total no. of SDOs monitored_
Certified Laboratory j)a.v1*5 t- Lab # a I t 17
Lab #
Stormwater Discharge Outfall (SDO) No. 1 VMA Outfall? Yes ❑ No
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No
Was this outfall ever in Tier 2 during the past year? Yes ❑ No ❑
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Outfall No.
Total Rainfall,
inches
Total
Suspended
p
Solids (TSS),
rn ll
pH,
SU
Non -polar O&G
(EPA Method
1664 (SGT-HEM)),
mgll (VMA)
NapaKabk
New Motor Oil
Usage (gallmo. ?
itapprkable
Stormwater
Benchmarks
Indka3a NO Fi.Q4Yfl:
aav+xach
Circle BanChmark
100lSO
fi.0-9.0
15
>55 gaUmo. avaraga requires TSS and
Fiun•polartl&Gmonlforing
Date Sample`:§
Collected,
Permit Date 611/2017 — 613012022
Last Revised 8-22-2015

Certificate of Coverage No. NCG 14 ❑O ®T0
CERTIFICATION
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly r ponslble for gathering the information, the information submitted is, to the best of my
knowledge and belie , tru , accurate, and complete. I am aware that there are significant penalties for
submitting false i
(Required by 40 CW
Signature
Date 57-y-2 -
n, including the possibility of fines and imprisonment for knowing violations."
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct - Central Files is housed in D WR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 8/112017 — 6130/2022
Last Revised 8-22-2015