HomeMy WebLinkAboutNCG140105_MONITORING INFO_20190207STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
�v��j�Di D -s
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ I �� o %
YYYYM M D D
-�: STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE N0. NCG 4 O� D -J
FACILITY NAME: A
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR:
SAMPLING PERIOD: ❑,rJuly-December January -June
COUNTY CR N
PHONE NO. ` _}
ADD TO LISTSERVE? ❑YES ❑ND EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA []Trout ❑Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)t
PH
{Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total
Rainfall"
(in)
In Tier 2
Monthly
Monitoring?
(y/nj
# of Months in Tier
2 Samplingz
6-92
1002'
-
-
-
-
CENTRAL
FILES
j
MVIF SE77TCF7
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.
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 TSS benchmark values are 100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I.
For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-50/30/2015 Date of last PH meter calibration: Last Revised 7/13/11
Page 1 of 2
Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > SS gal of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
(mo/dd/yr)'
pH
(Standard
Units)
TPH using method
1664A SGT-HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
a
Rainfall
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
1t of Months
in Tier 2
2
2'
Sampling
15
lU
_
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one cot) of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample for at end of monitoring period
in case of "No Flow") to:
Division of Water Quality
Attn: DWCI 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
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 Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2of2
STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE N0. NCG 4_Q _L
FACILITY NAME: CAS
PERSON COLLECTING SAMPLES ►!►>�
CERTIFIED LABOR;4TORY Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 26 1 18
SAMPLING PERIOD: ® July -December [j January -June
COUNTY
PHONE NO, (2,4�k) 55
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA []Trout ❑Other.
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)1
PH
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total a
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Samplingz
-
-
6-9
100 '
-
-
-
I
Q
REI_-IVEH
hr-r A 1'7' �n10
CENTRAL F1LEE
vur[ J s 1UN
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 TSS benchmark values are 100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l.
For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015
Last Revised 7/13/11
Page 1 of 2
Date of last pH meter calibration:. " /?—
P;;rt B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > SS gal of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
(mo/dd/yr}1
p.
(Standard
Units)
TPH using method
1664ASGT-NEM
(mg/L}
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
a
Rainfall
(in)
New Motor Oil
Usage
(gal/month)
In Fier 2H
Monthly
Monitoring?
(y/n)
ft of Months
in Tier z
2
Sampling
6-9
15
23
100 '
-
-
-
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO 2
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this I}MR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of samule for at end of monitorins period
in case of "No Flow") to:
Division of Water Quality '
XAttn: 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.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
IIf, /-13'1$
(Signature of Permittee) (Date)
Permit Date., 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2
STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCO140000
CERTIFICATE OF COVERAGE NO. NCG14 D ( 0 `�
SAMPLE COLLECTION YEAR: Zo1$
FACILITY NAME: C � 1,
SAMPLING PERIOD: July -December January -June
PERSON COLLECTING SAMPLES �1f4��t p0 N �Q { 5� y i S5
CERTIFIED LABORATORY Lab # rr
Loh # ` " 3 ZMD TO LISTSERVE? []YES ❑NO EMAIL:
OPTIONAL INFO: ICES HARGING TO CLASS: []SA ❑HQW ❑PHA ❑Trout []Other
Part A. Stormwater Monitoring Requirements I)WR fi r*7lnA,
Outfali No.
Date Sample
Collected
(mo/dd/yr OR
NO FL0W)1
pH
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total 4
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(Y/n)
# of Months in Tier
2 Sampling:
i
I 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.
2 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 T55 benchmark values are 100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/i.
For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Date of last pH meter calibration:
Last Revised 7/13/11
Page 1 of 2
Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > SS gal of new motor oil/month -- averaged over a calendar year.
Outfall
No.
Date Sample
Collected
(mo/dd/yr)j
pH
(standard
Units)
TPH using method
1664AS6T-NfM
(mg/L)
Total Suspended
Solid;
(mg/L)
Event
Duration
{minutes}
Total
Rainfall
(in)
New Motor Oil
Usage
(gal/month)
in Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
:
Sampling
6-9
1s
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTEDTHE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail 00einal and one copv of this DMR f includins all "No Flow" & "No Dischanee" resorts) within 30 days of receipt of sample for 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 persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware that they re significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee) ! (Date)
Permit Date: 7/1/2011-60/30/201S
Last Revised 7/13/11
Page 2 of 2
STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE N0. N�fCG14 0 ! O
n
FACILITY NAME: L rI10% A IM
PERSON COLLECTING iWPLES i JArT Ira [ s y
CERTIFIED LABORATORYjLQj/tde;,A&4,T J Lab # to
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 46 / 1
SAMPLING PERIOD: [ 3uly-December ❑ January -June
COUNTY
PHONE NO. ('Zy;`) 3_7- `t 45'5'
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA ❑Trout []Other,
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
PH
{Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes}
Total
,
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n'
# of Months in Tier
2 Samplinga
-
-
6-9
100 '
-
-
-
-
�S- 24 - 1-7
f'
!YAM
Fi
1S'n_
4/l
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.
2 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 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l.
For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-50/30/2015 1 Last Revised 7/13/11
Page 1 of 2
Date of last PH meter calibration: o ;Y17
Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using } 55 gal of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
{mo/dd/yr}1
pH
(Standard
Units)
TPH using method
1664A 5GT-HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
c
Rainfall
(in)
New Motor oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
Win)Sampling
# of Months
in Tier 2
i
6-9
15
100
-
-
-
-
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one cony of this f3MR (including all "No Flow" & "No Discharge" renortsl within 30 days of receint of sample for 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 MUSTSIGN 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
amAVre,that^e ale significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
''g-/r-17
(Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2
STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NC 14 0 / P
FACILITY NAME: A665 K4"_4u t7' x
PERSON COLLECTING SAMPLES IV -r e4l:�'nt—h
CERTIFIED LABORATORY&_.?4 ✓ 9,!2 ✓- 7 / lab It If
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 0017
SAMPLING PERIIIO�D, ❑ JuyI December ,January -June
COUNTY C" 14 (je c"
PHONE NO,
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA []Trout
❑Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)[
PH
{Standard
Units)
TSS
(mg/L)
Event
Duration
)minutes)
Total a
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
{y/n)
# of Months in Tier
2 SamplingZ
-
-
6-9
100 ,
-
-
-
-
iL
FEB 2 f .1
{'i A 1 4-,
[
WR SF CTII"'' w
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.
2 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 [lone until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l,
For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge. -
Permit Date: 7/1/2011-60/30/2015 Date of last pH meter calibration: ��/ i Last Revised 7/13/11
Page 1 of 2
Part,p: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
(mo/dd/yr)'
pH
(Standard
Units)
TPH using method
1564A SGr HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
,
Rainfalf
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
Wn)
rt of Months
in Tier 2
2
Sampling
6-9
15
100 '
-
-
-
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this DMR (including all "No Flow" & "No Discharee" reuorts) within 30 days of receipt of sample for 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 persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware t t there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
n.v�-��
(Signature of Permittee) ! (Date)
Permit Date: 7/1/2011-60/30/201S Last Revised 7/13/11
Page 2 of 2
tit
STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING F0RM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF C X-490!.
ERAGENO.NCG14D 1FACILITY NAME: A
PERSON COLLECTING AMPLES
CERTIFIED LABORATORY Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 201 11 _
SAMPLING PERIOD: July -December ❑ January -June
�✓ri COUNTY G A�
PHONE NO, (23Z) G
ADD TO LISTSERVE? DYES ❑NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA ❑Trout []Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)t
PH
{standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total 4
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 SamplingZ
6-92
100 ,3
-
-
-31
SEF
DWR
i
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.
2 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 TSS benchmark values are 100 mo, except when discharging to ORW, HQW, Trout, and PNA waters where they are So mg/I.
4 For each sampled measurable storm event the total precip'ftation must be recorded using data from an on -site rain gauge.
1EIVED
2 3 ZG1c
RAL FILES
SECTION
Permit Date: 7/1/2011-60/3D/2015 Last Revised 7/13/11
Page k of 2
Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month =averaged over a calendar year.
Qutfall
No.
Date Sample
Collected
(mo/dd/yr)'
pH
(standard
Units }
TPH using method
1664A 5G7-HEM
m /L
( g }
Total Suspended
Solids
m L
( g/ }
Event
Duration
(minutes)
minutes
Total
a
Rainfall
[in)
New Motor Oil
Usage
(gal/month }
1n Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
Sam lin
p gZ
6-3
is 2
100 ,
-
-
-
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NOX
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Original and one coov of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample for 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 persons directly responsible for gathering the information, the information submitted is, to the best of my knowWge and belief, true, accurate, and complete.
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 Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2of2
STORMWATER DISCHARGE OUTFALL
GENERALPER
CERTIFICATE OF CO RAGE N0. NCG14 0 ! 0FACILITY NAME: O ".0
PERSON COLLECTING SAMPLES r.?G
CERTIFIED LABORATORY Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
(SDO) - Semi -Annual MONITORING FORM
MIT NO. NCG140000
SAMPLE COLLECTION YEAR:
SAMPLINGPPRIOD' ❑ July -December )Q Fe/Z
COUNTY
PHONE NO, t Z��_ ir,37'—
ADD TO LISTSERVE? ❑YES ❑NO EMAIL: :3
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA [—]Trout ❑Other
butfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
pH
(Standard
Units)
TSS
(mg/L}
Event
Duration
(minutes)
Total
,
Rainfall
{in}
In Tier 2
Monthly
Monitoring?
(y/n'
# of Months in Tier
2
2 Sampling
-
-
6-9
100 'IUL
-
-
V
v �4;J
CE
NTRAi Irn
I..rt
K ��CTICT�
° 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.
2 If a value is in excess of the benchmark, or outside the benchmarks 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 TSS benchmark values are 100 mg/l, except when discharging to ORW, HOW, Trout, and PNA waters where they are 50 mg/I.
4 For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2
s
Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
(mo/dd/yr)
PH
(standard
Units)
TPH using method
1664A SGT-HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
a
Rainfall
(in)
New Motor Oil
Usage
(gal/month)
In Tier z
Monthly
Monitoring?
Wn)
# of Months
in Tier 2
Sampling2
6-9
15
IOO
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK £XCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail DriRinal and one coov of this DMR (including all "No Flow" & "No Discharge" reports) within 3D 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 persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee) i (Date) -
Permit Date: 7/1/2011-60/30/2015
Last Revised 7/13/11
Page 2 of 2
STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 O 1 D 5-
FACILITY NAME: i ,/ r _
PERSON COLLECTING SAMPLES It iS
CERTIFIED LABORATORY j�;��rw �/_ Lab r# 10f2
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR, Z01 5 1 RECEIVE
SAMPLING PERIOD: July -December ❑ January -June AUG 0 3 2015
COUNTY G/gOv,
PHONE NO. {ZSZ}_ G 3?- �� CENTRAL FILES
DWR SECTION
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
pH
(Standard
Units}
TSS
(Mg/0Monitoring?
Event
Duration
(minutes)
Total
Rainfall°
(in)
In Tier z
Monthly
(y/n)
# of Months in Tier
2 Samplingz
-
23-►5
I 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.
2 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 TSS benchmark values are 100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/1.
4 For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-50/30/2015 Last Revised 7/13/11
Page 1 of 2
Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outfail
No,
Date Sample p
Collected 1
(mn/dd/yr}
pH
(Standard
Units)
TPH using method
1664A SGT-HEM
(mg /L)
Total Suspended
Solids
(mg/L)
Event
Duration
{minutes)
Total
,
Rainfall
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
2
Sampling
6-9
15
100
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑
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 for at end of monitoring period
in case of "No Flow" to:
Division of Water Quallty
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 qu lified personnel operly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persXdire^ reW + e for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am awar hdt t r a g 'cant penalties for submitting false information, including the possibility of fines and im risonment for knowing violations.
(Signet a of Permit e) ! (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2
~` STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 ID 1 D '�
FACILITY NAME:
PERSON COLLECTING SAP41PLES
CERTIFIED LABORATORY jAf;0�,r7_ /_ Lab # 1oQ3
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 20/j57
SAMPLING ^PERIOD: �} July -December [January -June RE^�r
COUNTY [ J" L.� 1 V�
PHONE NO. ( ) (�3�{-`t�s
MpY ADD TO LiSTSERVE? []YES ❑NO EMAIL: 1 �)�
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑ K RA ILES
ECT10tj
Outfall Na.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
PH
(Standard
Units)
TS5
(mg/0Monitoring?
Event
Duration
(minutes)
Total a
Rainfall
(in)
In Tier 2
Monthly
(y/n)
# of Months in Tier
2 Sampling2
-
-
6-9�-
/
y' Zo
l 7
14Q
37
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.
2 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.
a TS5 benchmark values are 100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I.
`For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
RU
L.L.-.
Permit Date: 7/1/2011-60/30/2013 ; Last Revised 7/13/11
Page 1 of 2
. 't .
Part B: 1'2hicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor ail/month — averaged over a calendar year.
-
Outfall
No.
Date Sample
Collected
(mo/dd/yrJt
pH
(Standard
Units)
TPH using method
1664A 5GT NEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
a
Rainfall'
(in)
New Motor oil
Usage
(gal/month)
In Fier Z
Monthly
Monitoring?
(y/n]
I
�
# of Months
in Tier 2
Z
5ampiing
6-9
15
100 '
-
-
-
-
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEED CES AT ANYONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NOX
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Original and one coov of this DMR (including all "No Flow" & "No Discharge" resorts! within 30 days of receipt of sample for at end of monitoring period
in case of "No Flaw") to:
Division of Water Quallty
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
thoNresoq
rectly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
amtere are significant penalties for submitting false information, intruding the possibility of
fines and imprisonment for knowing violations."
7- 2.7
(Sig ture Permittee) ' (Date)
Permit Date: 7/1/2011.60/30/2015 Last Revised 7/13/11
Page 2 of 2
STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14
FACILITY NAME:
PERSON COLLECTING SAMPLES i
CERTIFIED LABORATORYEA-�v0'W,&2 4c1_,u Lab # 1D93
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Reouirements
SAMPLE COLLECTION YEAR:
SAMPLINGYERIOD:July-December ❑ January -June
COUNTY /fir _
PHONE NO. (2SZ) 7- W5'6"
ADD TO LISTSERVE? ❑YES [-]NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
pH
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes}
Total
u
Rainfall
din)
In Tier 2
Monthly
Monitoring?
(y/n)
N of Months in Tier
2 Samplingx
-
-
6-9
100 2,3
-
-
_ /
71
-2
Z
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.
2 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 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I.
`For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
RECEIVED
SEP 19 20=4
DINR SECT10N
Permit Date: 7/l/2011-60/30/2015
Last Revised 7/13/11
Page 1 of 2
Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gat of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
(mo/dd/yr)1
PH
(Standard
Units)
TPH using method
1664,4 56T-HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
a
Rainfall
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
g of Months
in Tier 2
2
Sampling
6-9
15
100 ,
-
-
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this DMR (including all "No Flow" & "No Dischar?e" reports) within 30 days of receipt of sample for at end of monitorine 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 mydirection or supervis}on 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.
am aware �the i !cant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signatu of Per (Ittee) ' (Date)
Permit Hate: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2
STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 6
FACILITY NAME: /it
?iD1(a'ArO�L
PERSON COLLECTING SAMPLES Ck4f-1 vlk•►bo.,?
CERTIFIED LABORATORY ffA&2AWAkj : 1, Lab # /9
Lab t#
OPTIONAL INFO:
Part A. Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: _ 701z/
SAMPLING PERIOD: ❑ July -December January -June
COUNTY _�ie�4✓rrJ _
PHONE NO. (fsz &37- �115T
ADD TO LISTSERVE? DYES []NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)t
PH
(Standard
Units)
T55
(mg/L)
Event
Duration
(minutes)
Total
,
Rainfall
(inl
In Tier 2
Monthly
Monitoring?
(Y/n)
# of Months in Tier
i
2 Sampling
-
-
6-9
10D-
3- 7-
Z-s
I
1 If "NO FLOW" o "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
If a value isjn 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. Tler 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I.
`For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
A5'
Permit Date: 7/1/2011-60/30/2015 1 Last Revised 7/13/11
Page 1 of 2
Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal'of new motor all/ —averaged over a calendar year.
Outfall
No.
Date Sample
collected
(mo/dd/yr)j
pH
(Standard
Units)
TPH using method
1664.4 SGT-HEM
[mg/L}
Total Suspended
Solids
(mg/1)
Event
Duration
(minutes)
Total
,
Rainfall
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
R of Months
in Tier Z
2
Sampling
6-9
15
100
-
-
a
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ONO El
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑ -
REGIONAL OFFICE CONTACT NAME: �-
Mail Original and one copy of this D_MR (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 persons directly responsible for gathering the information, the information submitted is, to•the best of my knowledge and belief, true, accurate, and con pl'ete. i', ,
am awarq th t there are sigrnifica t penalties for submitting fa€se information, including the possibility of fines and imprisonment for knowing violations." �.
(Signature of Permittee) '; (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7�/13/11
Page 2 of 2