NCG140399_MONITORING INFO_20150724

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v u&
DOC TYPE
[I HISTORICAL FILE
B. MONITORING REPORTS
DOC DATE
❑ a4l 6 bra'
YYYYMMDD

. STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERA. PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 O _3 9 9
FACILITY NAME: S.T. WOO'TFJy
PERSON COLLECTING SAMPLES CJ fi_ /COMAI
CERTIFIED LABORATORY 5GS Lab # S/S/
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: r2 O /S'
SAMPLING PERIOD: ❑ July -December N January -June
COUNTY QA15LlJCtiJ
PHONE NO. ( .7L2)
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: [_]SA ❑HQW ❑PNA ❑Trout ❑Other,
Outfall No. -
Date Sample
Collected
(mo/dd/yr OR
1
No FLOW}
pH
(Standard
Units)
TSS -
(mg/L)
Event
Duration
;(minutes)_
Total
4
Rainfall
(in}
In Tier-2-
-Monthly
Monitoring?_ -
iv/n1
# of Months in Tier
z
= 2 Sampling
-
6-9
100 '-
S-/l -aots
,9,
ND 6 as-M5AYao
3
o
e.
. RECFIVLU
GEN I
ntinrn
KAL r1L.t5
c�n �r1AI
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
z If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit, Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TS5 benchmark values are 100 mg/i, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l.
4 For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
NO
R
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1of2

iL
Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
.. .'F�
r=,•
• ;.,-��; ..� .
�.• No:
E;
=.T. t.
1 .�Y
]�����€ is �-
- .«r4v S
lac s.-.t% ', s,•'r
Date Sample ._
�; y
• : :Collected —
f.
•: M'
'¢"e- it - w
s...r �, }:tt3r� i�; rc�
_/t •:
o H = '3
.a ; .r.yP, i ; f t,
� (Standard;;' :
.�,
units
1-
y. �t "�...�
-»�tl< o$'� :S?, t -
gTPli?iisinmethod :
g _:.
> ,34SgA SGT-NfMw�
.T..,;�
mL
.A Y''�a
•,2t <. x +"f
'��a� t? �p
F :i:... •t.:
Total Sus endi=d'
, .= P _
� F = �' •-Solids �-�
r �R F
m L <:
sd
s'_a. !"S_.
-fi `f'YtZd ...3 "z
s i� fio�`„ r .t �� .��
f`
= ";Event [. '
�f
;.r Qufation,��::
minutes
i
"�. t t
�'a. i r�._ ��` :.-tea:
'is.'�: M
f--s
'r; .Totals "!
E �;, ,,
E.Rai>lfall � �'
�
'm
3s °j'�'.'e'3
Sb
s��'�'c��,�•t ;.3; ,�cZ�E<.�.
-.a .: C.� �-�
ft: a. f rx
New Motor Oil
� � .�lJsa e,.
, v g
of rimontli r
JH ,.,,, f
t ';
3 €�,�, s � _ (
�� 'µ:.3""-st�S..��+'i�-.^Yd
�::En-;Tier:.2
i, :Month)
',:jiA-1 3 A
a_ A -f7`Y i� .§
�-� .r
YY
:Y .' .• <E 'a
Months
i ;i�, ,
Sa`m lin
!`i -•ab.,
ra 1 J•
_'��r.. :'° � �r,.,�
i i
r
S LAi .�
+����
d+' _ T;
1..
_� s-.=_6 f
,i-S. .�i - "•J
a ^.r •s-:�
3 ��. • 15 E- � �:.; .. �
v'�j .,
m rt',." .,:
� M . e.
i il.i r3 �eJ
: s•, �i. i.
:�' .� �
�!3..L S y +S
a � �
,.," fl'
y F .x. �. r`
€ f � �•
y,.,�-. Ei
ie;.• r i'".k
� _�.:�:, �,r ..�
7;.-'C" fi
1 E-
�.•� ,:.�-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANYONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NOX
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period
in case of "No Flow") 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 perso tly responsible for gather' g the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am awar hat thele are sign fi .an�penplti for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(SignatuWooermittee)
(Date)
— V—,2d/3
Permit Date: 7/1/2011-60/30/2015
Last Revised 7/13/11
Page 2 of 2