NCG020301_MONITORING INFO_20100712

- - STORMWATER DIVISION CODING SHEET ---
RESCISSIONS.
PERMIT NO.
IV�CgO�U3U
DOCTYPE
CJ COMPLETE -FILE -HISTORICAL
DATE OF
RESCISSION
❑
YYYYMMDD

ANNUAL SUMMARY )N R - STORN :WATER RECEIVED
k.C. Deot, of F.NR
SEND TO CENTRAL OFFICE * JUL 12 2010
STORUWA TER DISCHARGE OUTFALLS (SDO) a gionn•Salem
Regional Df.'ice
GENERAL PERMIT NO. NCG020000 --
*Report ALL STORMWA TER Monitoring Data on this form (including NoTlow and No Discharge and Permit Limit Violations) by MARCH 1 ofeach year,
CERTIFICATE OF COVERAGE NO. NCGO2 L Q -017
FACILITY NAME: Sa Il
PERSON COLLECTING SAMPLES avi' �r�� !/ �•
CERTIFIED LABORATORY a / Lab # 3� _
Lab #
Part A: Stormwater Monitorins Requirements
SAMPLE C LLTIO 1 YEAR:
COUNTY A C- ( aty-
PHONENO.Q3L)k2-3, 5-- 1
ADD TO LISTERVE? YES q NO 29 EMAIL:
TOTAL RAINFALL: 1z INCHES
EVENT DURATION: MINUTES)
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in
Tier 2
Sampling Z
Total Flow
' (MG)p
Total Suspended
Solids
(mom)
Turbidity a
(NTU)
'
Settleable Solids
(nil/1) '
-
-
-
-
1003,4
See Footnote 3,50.1
Now
14t-/-os-
o
1, 91 7
134
0rl r' ij 2,Vl v
Z. O z
Z g
3
z
I If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here and the Date Range.
2 Per NCG02: Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
3 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.
4 TSS benchmark values are 100 mg/l except in ORW, HWQ, trout, and PNA waters where they are 50 mg/l.
'The discharge shall not cause an instantaneous measurement of the turbidity of the receiving water to exceed: 10 NTU for freshwater streams, lakes, and reservoirs designated
as trout waters; 25 NTU for all lakes and reservoirs, and all salt waters; 50 NTU for all other streams and surface waters. Turbidity may be monitored at the SDO.
Alternatively, the permittee may choose to monitor turbidity in the receiving water, directly upstream and downstream of the SDO. _
Permit Date: 1/112010-12/31/2014 Last Revised 01-19-10
Page I of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month on average
No. O
No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2Z
Sampling
New Motor Oil
Usage
(gaumonth)
Total Flow
(MG)P
TPH using.
method 1664A
SGT-HEM
m /I
Total Suspended
Solids,
(mg/1)
pH,
(Standard
Units)
-
-
15
100
6-9
`17
S-( 3
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEENDENCES ,
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES [-]NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO L�J
WHO AT THE REGION HAVE YOU SPOKEN WITH? A,' e�? p 6,4 'p—
MAIL, ORIGINAL•AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW". "NO DISCHARGE" & LIMIT
VIOLATIONS) BY MARCH l OF EACH YEAR 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 INFORMA TION 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)
Permit Dato: 1/172010-128112014 Last Revised 01-19-10
Page 2 of 2

STORMWATER DISCHARGE MONITORING REPORT (DMR)
11 Please Mail Original And One Copy To Mailing Address Below I
GENERAL PERMIT NO. NCG020000
Part A: Racility Information
Samples Collected In Calendar Year: 'Zt7(7% (all samples shall be reported within 30 days following monitoring period)
Certificate Of Coverage No. NCG02 00 0 0 _ _ County of Facility
Facility Name Sfi,'r! tr, c A ram, Name of Laboratory
Facility Contact ✓.' Q/H/n v } ! Lab Certification #
Facility Contact Phone No.
Part B: Land Disturbance and Process Area Monitoring Requirements
Date
50050
00530
00076
00545
Outfall
Receiving Stream
Sample
Total
Total
Settleable
No
Name
Collecte
Flow
Suspended
Turbidity
Solids
d
Solids
motdd/ r
MGD
MO
NTUs
m1/I
4i� 11
>� IDwur
r1O
.3q6
/7-3
'ZZ,O
.1
0A L
et/Lr dQ
Part D: Storm Event Characteristics
Total Event Precipitation (inches): �.
Event Duration (hours): 9 17 ,-P,(t
Part E: Certification
Part C. Vehicle Maintenance Monitorin, Requirements
RECEIVED
N.C. Dept of ENR
APR 0 9 2009
Winston-Salem
Regional office
No. O
No.
Receiving Stream
Name
Date
50050
00556
00530
00400
Sample
Collecte
d
Total
Flow
Oil and
Crease
Total
Suspende
d Solids
pll
moldd/ r
MG
I m
m
unit
Total Event Precipitation (i!��
Event Duration (hours):
(if a separate storm event is sampled)
"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 violatio s."
(Signature of Permit (Date)
fart I':' ,4lailing Address
Attn: Central Files, DENR, N.C. Division of Water Quality, 1617 Mail Service Center, Raleigh, NC 27699-1617
S W 11- 2d.i-b 12005

STORMWATER DISCHARGE MONITORING REPORT (DMR)
Please Mail Original And One Copy To Mailing Address Below
GENERAL PERMIT NO. NCG020000
Part A: Facility Information
Samples Collected In Calendar Year: Z119 0 ? (all samples shall be reported within 30 days following monitoring period)
Certificate Of Coverage No. NCG02 00 0 O County of Facility
Facility Name Sam W fmllrx. Zrr+C "-stray.. Name of Laboratory
Facility Contact INv,' ,--M o .? Lai) Certification ##
Facility Contact Phone No. 3( 34) 4 z I -- S^
Part B: Land Disturbance and Process Area Monitoring Requirements
Date
50050
00530
00076
00545
Outfall
Receiving Stream
Sample
Total
Total
Settleable
No.
Name
Collette
Flow
SuspendeU
Turbidity
Solids
d
Solids
mo/dd/yr
MGP
mea
NTUs
MIA
ow 11
" Ipwrsr
za o
,3�6
JL, 3
2Z.0
, J
e a
rb sr-^e.�►�.-r
3 Z6 9
2, J 8
33.0
3.
0
Part D: SYorm Event Characteristics
Total Event Precipitation (inches): J.
Event Duration (hours): !Z�roX
i
Part E: Certification
'
Part C.• Vehicle Maintenance Monitoring Requirements
RECEIVED
N.C. Dept. of ENR
APR 0 9 2009
Winston-Salem
Regional Office
Outfall
No.
Receiving Stream
Name
Date
5W50
00556
00530
00400
Sample
Collette
d
Total
Flow
Oil and
Grease
Total
Suspende
d Solids
pH
molddf r
MG
m
unit
_To
Total Event Precipitation (in s):
Event Duration (hours):
(if a separate storni event is sampled)
"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 tines and imprisonment for knowing violatio s."
(Signature of Permit (Date)
7
f'ur7l�': Mailing�Icicb•ess
Attn: Central Files, DENR, N.C. Division of Water Quality, 1617 Mail Service Center, Raleigh, NC 27699-1617
S W C]-243-012005