NCG140124_MONITORING INFO_20170405

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/l/
DOC TYPE
❑HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ ���7�y��
YYYYMMDD

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14_aL
FACILITY NAME: �� 14 —W4AS
PERSON COLLECTING SAMPLES,.AzrzV
CERTIFIED LABORATORY/i1 sn Lab #i
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR:
SAMPLING PERIOD: ❑ July -December January -June
COUNTY L� G�EV9:✓-P
PHONE NO. (�. ) iL✓�i�-� /
ADD TO LISTSERVE? [—]YES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout Tbther
Outfall No..
Date Sample
p
moodd QR
( / /y -
1
NO FLOW)
OH
( Standard
Units):
mSSL
( o.)
Event
Duration
(minutes)
:. : :_
Total
4
Rainfall?
jin)
In Tier 2
Monthly
. Monitorin
:. Wn)
# of Months mZ ier
2'Sampling,:_„
6-4
23
00,
OL
If "NO FI OW" or ,,Nn r)ISCHARGF. Enter "NO
FI OW" 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: 7/1/2011-60/30/2015
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.
Qutfall
Date Sample
H
usingmethod•
TotalSus Suspended;
""Eve
n
Total
aw Motor Oil
"
Monthly(Standard
nI,YT/ienr}
0 tTPi he
11eced
1664A SGT-HEM
Duration
Rainall
r
Usage
Monitoring?
in Tier 2:
(no/dd/yr):
UP
(m .. .
(glL}
(minutes).'.
o
amnits}
23
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 (or at end of monitoring period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQCentraI 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 w re that there are significalit pen (ties for bmittin false information, including the possibility of fines and imprisonment for knowing violations."
o-c;�;a1�
(Signature of Permittee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

STORMIMATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE' INO. NCG14 �,��
FACILITY NAME: &j-cUN[6W iC L'lu
PERSON COLLECTING SAMPLES „W
CERTIFIED LABORATORY_ �jra,�ry� Lab #72,
Lab It
OPTIONAL INFO:
Part A: 5torrmwater Monitoring Requirements
SAMPLE COLLECTION YEAR:
SAMPLING PERIOD: July -December ❑ January -June
COUNTY c..C.�Z�EG�S'Jh/}
PHONE NO. V�—
ADD TO LISTSERVE7 ❑YES [—]NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout []Other
Outfall No.
Bate Sample
Collected
(molddJYr OR
NO FLOW)'
pH
(Standard
Units)
TS5
(mg/L}
Event
Duration
(minutes)
Total
a
Rainfall
(in)
In Tier 2
Monthlyff
Monitoring?
(y/n)
of Months in Tier
2
2 Sampling
7 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 ff a uafuas is in excess of the bprichmark, 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 5arnples are, below the benchmark or within the benchmark range.
} TSS benchmark values are 100 mgfl, except when discharging to ORW, HQW, Trout, and PNA waters where they are SO mg/I
' For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
lVEC
0 201?
. FILES
DTION
Pe i n'iit pate: 7/1/2011.-60/30/201.5 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.
Outfall
No.
Date Sample
Collected
(mo/dd/yr)4
pH
(Standard
Units)
TPH using method
1664A 5GT 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)
# of Months
in Tier 2
Z
Sampling
6-92
is
100
-
-
-
-
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANYONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL, OFFICE CONTACT NAME:
Mail Odeinal 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 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 !mowing violations."
(Signature of Permittee)
Permit Date: 7/1/2011-60/30/2015
(Date)
Last Revised 7/13/11
Page 2 of 2

STORMWATER DISCHr,.,6E OUTFALL (SDO)
GENERAL PERMIT NO. NCG190000
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE OF COVERAGE NO. 1NfCG19.0038 7 13ECCIVEDSAMPLES COLLECTED DURING CALENDAR YEAR: 2016
j J " 0 LdIC (This monitoring report is due at the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
FACILITY NAME ATLANTIC MARINE SALES, INC. IENTRAt FILES COUNTY NEW HANOVER
PERSON COLLECTING SAMPLES _Jim Frei/ SwSG DWR SECTION PHONE NO. _(,910.) 256-991.1 _ �R
CERTIFIED LABORATORY Pace Analytical Lab # 12/ 40
SwSG Lab # 5054
Part A: Specific Monitoring Requirements
Outfall
No.
Date
Sample
Collected
mo/dd/ r
Total
Rainfall
inches
00530
00400
00556
01119
01104
01094
01114
Total
Suspended
Solids, m /L
pH
Standard
units
Oil &
Grease
m IL
Copper'
mg/L
Aluminum
mg/L
Zinc '
mg/L
Lead '
mg/L
Benchmark
-
-
100
Within 6.0--
9.0
30
0.007
0.75
0.067
0.03
001
05/18/16
0.39"
2.7
8.39
2.02
0.13
< 0.10
0.080
< 0.0050
004
05/18/16
0.39"
7.0
8.16
1.93
1.5
0.16
0.38
< 0.0050
0021003
Represented PX 001 and 004
If a value is in excess of the benchmark, or outside the benchmark range (for PH), you must implement the Tier I or Tier 2 responses in the General Permit.
Z Total recoverable.
3 These benchmarks are water hardness dependant. Values shown based on a hardness of 50 mg/L.
Solvent Management Plan Certification:
Mail original and one copy to: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit requirement
NCDEQ/ Division of Resources for managing solvents, l certify that to the best of my knowledge and belief, no leak, spill, or dumping of concentrated
Attn: DWR Central Files solvents into the stormwater or onto areas w ' are a posed to rainfall or stormwater runoff has occurred since filing the
1617 Mail Service Center last discharge monitoring report. I furthercertify th a ' ity is implementing all the provisions of the Solvent
Raleigh, North Carolina 27699-1617 Management Plan included in the Storm o ion P ention Plan." 7 r'
(Signature of Permittee) (Date)
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 o el p ly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons dire y respo s' e f gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am aware that t c a e i i ant penalties for submitting false information, including the possibility o fines and imprisonment for knowing violations."
-111L
(Signature of Permittee) (Date)
Permit Date: 10/1/2009-9/30/2014 SWU-253-092309
Page I of 1

STORMWATER DISCHARGE DUTFALL (SDO) - Semi -Annual MONITORING FORM
4._
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COV RAGE NO. N 5
G14J
FACILITY NAME: 2
PERSON COLLECTING SAMPLES ,G C�
CERTIFIED LABORATORY 54vt. Lab #
T Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 1=
SAMPLING PERIOD: ❑ July -December "January -June
COUNTY G�c A b
PHONE NO. CZ4y, ) -GAS
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)t
pH
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total
4
Rainfall
(in)
In Tier 2
Monthly
Monitoring,?
(y/n)
#of Months in z Tier
2 Sampling
6-92
1002.3
/1
X/
51
r�
r�
/r
JUN
v
r
.�
DWG SE
a
DYED
6 ZDib
,L FILES
:GTIONi
' 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/I, except when discfiarging.to'ORW, HQW,, Vout, and PNA waters where they are 50 mg/I. 1 �� . • : { , ,..?�
"For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 711/2011-60/30/2D15 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.
Outfall
No.
Date Sample
Collected
(mo/dd/yr)1
pH
(Standard
Units)
TPH using method
1664ASGT-HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
4
Rainfall
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
# of#.I.onths
in Tier 2
2
Sampling
6-92
is
1002.3
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: A,
Mail Orieinal and one copV of this DMR (includiniz 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
Raieigh, 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 a are that there are sjgni cant penal tie for submitting false information, including the possibility of fines and imprisonment for knowing violations."
-.rq . _14 _
t 3_
(Signature of Permittee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

—i—
lk
STORMNVATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
"I certify, tinder 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."
bnn--�- - (?- lj�
Signature of Permittee) to,
(Date)
Form SWU-255-072502
Page 2 of 2

I r
STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO, NC 14
FACILITY NAME:
PERSON COLLECTING SAMPLES 1&ftlyiz('lCr
CERTIFIED LABORATORY Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 0C.f/:
SAMPLING P IOD: ❑ July -December ,T January -June
COUNTY
PHONE NO. )
ADD TO LISTSERVE? OYES ONO EMAIL:
DISCHARGING TO CLASS: [—]SA ❑HQW ❑PNA ❑Trout
❑Other
Gutfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)t
pH
(Standard
Units)
TS5
(mg/L)
Event
Duration
(minutes)
Total
,
Rainfall
(m)
In Tier 2
Monthly
Monitoring?
(y/n)
N of Months in Tter
z
2 Sampling
-
6-92
1002,3
JUN
DWP
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.
/ED
'015
LES
ON
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2
I

z

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
z
Outfall
No.
Date Sample
collected
(mo/dd/yr)1
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
152
1002'3
-
-
-
-
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 copv 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 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
Permit Date: 7/1/2011-60/30/2015
( Date)
Last Revised 7/13/11
Page 2 of 2

STORMWATER DISCHARCaE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
` RECFIV So
CERTIFICATE OF COVERAGE NO. NCG14 C'V r I SAMPLE COLLECTION YEAR: JAS 2 �i
FACILITY NAME: y f�. SAMPLING P IOD.,July-December El January -June -
PERSON COLLECTING SAMPLES -MZWJ M , jG/CGS COUNTY � R C
CERTIFIED LABORATORY _ Lab # <100- PHONE NO. r4�/ jy1F''7�`o�J��-
Lab # ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
OPTIONAL INFO: DISCHARGING TO CLASS: []SA ❑HQW ❑PNA []Trout ❑Other
Part A: Stormwater Monitoring Requirements
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)
pH
(standard
units)
TSS
(mg/L)
Event
Duration
(minutes)
Total 4
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(yin)
# of Months in Tier
2 Sampling�
-
6-92
1002'3
-
-
-
-
j
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.
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

� l ,
Part 13: 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 SG7 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
Samplingz
6-9
is
100 '3
-
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING; VEHICLE MAINTENANCE)? YES F NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME: `"1D
ti
Mail Orieinal and one coov of this DMR (includine all "No Flow" & "No Discharpze" reports) within 30 days of receipt of sample for at end of rnonitorin� oeriop``"
in case of "No Flow") to:
Division of Water Quality
Attn: DWQCentral Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORIVIATION 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 property 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 a are that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
1113-15
(Signature of Permittee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDOY - Semi -Annual MONITORING FORM
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCMI."
4,fL
FACILITY NAME: ��C�c.11�t��O�j .Cid&,
PERSON COLLECTING SAMP
CERTIFIED LABORATORY ` d Lab # �
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitorine Reouirements
/ 01=441%miVE1
SAMPLE 'COLLECTION YEAR: �
SAMPLING PERIOD: July -December ❑ January -June
COUNTY C v4b CE
PHONE NO. ) Jy4'`'i�l�/ D
ADD TO LISTSERVE? []YES ❑NO EMAIL:
DISCHARGING TO CLASS: []SAA ❑HQW . ❑PNA ❑Trout []Other'[]Other'
Date Sample In Tier 2
pH Event Total
Collected TSS a Monthly # of Months in Tier
(
qutfall No. mo/dd/yr OR (Standard Duration Rainfall z
1 Units) (mg/L) (minutes) (in) Monitoring? 2 Sampling
NO FLOW) (V/n)
- - 6-9 100 ' - - - -
W
\N 12 2015
NTRAL FILES
R SECTION
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/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are So mg/l. _
For each sampled measurable storm event the totalprecipitation 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
W
\N 12 2015
NTRAL FILES
R SECTION
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/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are So mg/l. _
For each sampled measurable storm event the totalprecipitation 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

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
(ma/dd/yr)1
pH
(Standard
Units)
TPH using method
2664A 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 '
b
'
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-DMRjincludinP 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 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)
Permit Date:7/1/2011-60/30/2015
(Date)
Last Revised 7/13/11
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO) -'Semi-Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000 I .
CERTIFICATE OF COVERAGE NO. NCG14:V
FACILITY NAME:
PERSON COLLECTING SAMPLE- `
CERTIFIED LABORATORY �_ Lab#Z
Lab #
OPTIONAL INFO: c�rr
Part A: Stormwater Monitorine Reauirements
SAMPLE COLLECTION YEAR:
SAMPLING PERIOD: [July -December ❑ January -June -_
COUNTY
PHONE NO. �) 3�51 �51 ^�
ADD TO LISTSERVE? ❑YES ONO EMAIL:
DISCHARGING TO CLASS: [_]SA ❑HQW ❑PNA ❑Trout Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOWI1
pH
(Standard
Units)
TSS
(mg/L) -
%(minutes)"
Event
' � ••
Duration.'
Total
a
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(Y/n)
# of Months in Tier
Z •_
2 Sampling
„
-
6-9
too
-
a
,
27iy
-o
CEN 1
.' _
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. • , t . ,
2 If a value is in excess of the.benchmark, or outside the.benchmark range-jor 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 So mg/I, ' • '
a For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permif'Date: 7/1/2011-60/30/2015 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
No. O
No.
Date Sample
Collected 1
(mo/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)
g of Months
in Tier 2
Sampling2
6-9
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 Orieinal and one coov of this DMR (includine 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 forgathering the information; the information submitted is, to the best of my knowledge and belief, true, accurate, and,complete. I .
;ama are that there are sig ificant 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/].1
Page 2 of 2