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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