HomeMy WebLinkAboutNCG160013_MONITORING INFO_20190123STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/vC�'
DOC TYPE
❑HISTORICAL FILE
l� MONITORING REPORTS
DOC DATE
❑ � 0 I i!ol c) 3
YYYYMMDD
Semi-annual Stormwater Discharge Monitoring Report (DMR)
_t for North Carolina DEMLR General AMI
t No. NCG160000 - Asphalt
Date submitted .
CERTIFICATE OF COVERAGE NO. NCG16 D 0 1 3
FACILITY NAME Fred Smith Company -Holly Springs Asphalt Plant
COUNTY Wake
PERSON COLLECTING SAMPLES Austin Pote
LABORATORY ESC Lab Sciences Lab Cert. ie# ENV375
Comments on sample collection or analysis:
None
Part A: 5tormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Year 5 Period 2
SAMPLE PERIOD [] Jan -June ❑ July -Dec
or ❑■ Monthly( January (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
RECEIVED ❑Zero -flow ❑Water supply ❑SA
QOther class C
JAN 2 3 2019
CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE
DWR SECTION
❑ No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
Benchmarks
-
-
100 mg/L or 50 mg/L
001
01 /04/2019
0.73
31
002
No Flow
003
01/04/2019
0.73
92
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they -must be reported in the format, "<XX mt;/L" where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 1, or Tier 3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inchee
Non -polar O&G by EPA
2664 (SGT-HEM)
Total Suspended Solids
Benchmarks =W=>
_
-
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
(Vote: If you report a sample value In excess of the benchmark, you must implement Tier 1, Tier 2, or Tier responses. See General Permit text.
FOR PART AAND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL7 YES 0 NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE A5 REQUIRED BY THE PERMIT? YES 0 NO ❑
REGIONAL OFFICE CONTACT NAME: 9111 Denton
Mail an original and one copy of this DMR including all "No Discharge" report within 30 days of recei t of the lab results for at end of monitorin eriod
in the case o "No Dischar e" reports) - to:
Division of Water Resources
Attn: DWR 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."
is-,
(Signature of Permittee)
6- fiy
(Date)
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 2 of 2
Semi-annual Stormwater Discharge Monitoring Report (DMR)
' for North Carolina DEMLR General P rmit No, NCG160000 -Asphalt
Date submitted
CERTIFICATE OF COVERAGE NO. NCG16 0 0 1 2
FACILITY NAME Fred Smith Company -Wake Forest Plant ..._
COUNTY Wake
PERSON COLLECTING SAMPLES Austin Pote
LABORATORY ESC Lab Sciences Lab Cert. # ENV375
Comments on sample collection or analysis:
None
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Year 5 Period 2
SAMPLE PERIOD ❑■ Jan -June ❑ July -Dec
or ❑ Monthly' _ (month)
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
❑Zero -flow ❑Water Supply [:]SARECEIVED *Other class WS-IV; NSW
,BAN 2 3 2019
CENTRAL FILES
uWR SECTION
PLEASE REMEMBER TO SIGN ON THE REVERSE -)
❑ No discharge this period?Z
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Total Suspended Solids
Benchmarks ===>
_
-
100 mg/L or 50 mg/0
001
01/04/2019
0.62
35
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z for sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
° See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L". where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must Implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019 5WU-252, last revised 9/17/2014
Page 1 of 2
_,mart B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?'
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks ===>
_
-
15 mg/L
100 mg/L or 50 mg/0
Footnotes from Part A also apply to this Part B
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO 0
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ■0
REGIONAL OFFICE CONTACT NAME:
Mail an orlainal and one cony of this DMR, includina all "No Discharae" reports, within 30 days of receipt of the lab results (or at end of monitorina period
in the case of "No Discharae"reports) to:
Division of Water Resources
Attn: DWR 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 Perm ttee (Date)
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 2 of 2
Semi-annual Stormwater Discharge Monitoring Report (DMRj
for North Carolina DEMLR General Per No. NCG160000 - Asphalt
Date submitted O 12
CERTIF16TE OF COVERAGE NO. NCG16 0. 0 1 2
FACILITY NAME Fred Smith Company -Wake Forest Plant
COUNTY Wake
PERSON COLLECTING SAMPLES Austin Pate
LABORATORY ESC Lab Sciences Lab Cert. # ENV375
Comments on sample collection or analysis:
None
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Year 5 Period 1
SAMPLE PERIOD ❑ Jan -June ❑! July -Dec
or ❑ Monthly' month
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
❑Zero -flow ❑Water Supply []SA
Mother Class WS-lv; NSW
PLEASE REMEMBER TO SIGN ON THE REVERSE -->
❑ No discharge this period?2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
Benchmarks ===>
-
-
100 mg/L or SO mg/L
001
12/10/2018
0.79
38.0
RECEIVED
JAN 15 2019
CENTRAL I"ILC'.
D11113 SECT1019
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L". where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period ?2
Outfall No.
Date Sample
Collected"
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks ===>
_
-
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO 0
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO 0
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of -this MR, includinn all "No Discharge" reports, within 30 days of receipt of the lab -results (or at end of monitoring period
in the case o "No Discharge" reports) to:
Division of Water Resources
Attn: DWR 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)
01 O /
(Date)
Permit Date:10/1/2014-9/31/2019
SWU-252, last revised 9/17/2014
Page 2 of 2
• STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year 2p18
Revised 911712014
General Permit No. NCG160000
Certificate of Coverage No. NCG16®®❑❑❑
This monitoring report summary is due to the DEMLR Regional Office no later than November 1 of
each year.
Facility Name: Fred Smith Company Wake Forest Plant
County: Wake
Phone Number: (919 ) 783-5700
Total no. of SDOs monitored 1
Part A. Outfall No. 001 (rase multiple sheets for multiple outfalls)
Is this outfall currently in Tier 2 (monitored monthly)? Yes❑ No ✓❑
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No ✓❑
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Outfall 001
Tot al Rainfall,inches
00530
TSS, mglL
Benchmark
N/A
501100
Date Sample Collected,
molddlyr
=
M
01 /29/2018
1.89
18.0
12/10/2018
0.79
38.0
RECEIVED
JAI 18 Z019
CENTRAL FILL-8
LANR SECTIC N
Page I 1
Part B'On-Site Vehicle Maintenance Outfall No.
K'fthis outfall currently in Tier 2 (monitored monthly)?
Was this outfall ever in Tier 2 (monitored monthly) during the past year?
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Yes ❑ No ❑
Yes[:] No
Page 12
Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted 02/22/2018
CERTIFICATE OF COVERAGE NO. NCG 16 0 0 1 2
FACILITY NAME Fred Smith Company -Wake Forest Plant
COUNTY Wake
PERSON COLLECTING SAMPLES Martin Richmond
LABORATORY ESC Lab Sciences Lab Cert. ## ENV375
Comments on sample collection or analysis:
None
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Year 4 Period 2
SAMPLE PERIOD ■❑ Jan -June ❑ July -Dec
or ❑ monthly' month
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flaw ❑Water Supply ❑SA
Other Class WS-IV; NSW
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Outfall No.
Date Sample
Collected"
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
Benchmarks ===>
-
-
100 mg/L or 50 mg/L
001
01 /29/2018
1.89
18.0
No discharge this period?2
RECEIVED
,Ills 2 0 2018
CENTRAL FILES
DWR SECTION
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
7 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks ===>
_
-
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART AAND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER ATANY ONE OUTFALL? YES ❑ NO Q
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑N
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge," reports, within 30 days of receipt of the lab results for at end of monitoring period
in the case of "No Discharge" reports) to:
Division of Water Resources
Attn: DWR 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 foeb information, including the possibility of fines and imprisonment for knowing violations."
re of Pe
02/22/2018
(Date)
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 2 of 2
" Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted 12/06/17
CERTIFICATE OF COVERAGE NO. NCG16 0012
FACILITY NAME Fred Smith Companv - Wake Forest Plant
COUNTY Wake
PERSON COLLECTING SAMPLES Matthew James LABORATORY ESC Lab Sciences Lab Cert. # ENV375_
Comments on sample collection or analysis:
None
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Year 4 Period 1
SAMPLE PERIOD ❑ Jan -June EX] July -Dec
or ❑ Monthly) (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
[X]Other Q NSW
PLEASE REMEMBER TO SIGN ON THE REVERSE -)
❑ No discharge this period?Z
outfall No.
Date Sample
1
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Total Suspended Solids
Benchmarks =__>
-
-
100 mg/L or 50 mg/L
001
11/09/17
0.30
62.5
RF-CEI ED
JAN 19.2018
0R SECTION
INFORMATION PROCESSING UNIT
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format "<XX•m L" where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
No discharge this period?2
Outfail No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
s
inches
Non -polar O&G by EPA
1654 (5GT-HEM)
Total Suspended Solids
Benchmarks
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note: if you report a sample value in excess of the benchmark, you must implement Tier .1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO [XI
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an on final and one copy of this DMR including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitoring eriod
in the case of "No Discharge" reports) to:
Division of Water Resources
Attn: DWR 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 alified personnel er and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those p s directly re nsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
an tfy thereafe penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
V/z A -
gn re of Permittee) Date)
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 2 of 2
Semi-annual Stormwater Discharge Monitoring Report jDMR}
for North Carolina DEMLR General Permit'No. NCG160000 - Asphalt
Date submitted 04/06/17
CERTIFICATE OF COVERAGE NO. NCG16 0012. _
FACILITY NAME Fred Smith Company - Wake Forest Plant
COUNTY Wake
PERSON COLLECTING SAMPLES Matthew James
LABORATORY ESC Lab Sciences Lab Cert. # ENV375
Comments on sample collection or analysis:
None
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Year 3 Period 2
SAMPLE PERIOD [x] Jan -June ❑ July -Dec
or ❑ Monthly) (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
[X]Other C; NSW
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches;
Total Suspended Solids
Benchmarks =__>
_
-
100 mg/L or 50 mg/L
001
03/14/17
0.40
19.0
No discharge this period?z
iil�C4�,/
'APR ��D
a 2017
DERV Ply
7/6�
2 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain'gauge. - Unattended sites may be eligible for a waiver of the rain gauge requirement.
° See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mR/L", where XX is. the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2
PeA B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?'
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24=hour rainfall
amount,
Inches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
_
-.
15 mg/L
100 mg/L or 50 Mg
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
+ A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO [XI
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period
in the case of "No Discharge" reports) -to:
Division of Water Resources
Attn: DWR 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 thWthere are significant peKalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee]
4VjL-
(Date)
Permit Date: 10/1/2014-9/31/2019
SWU-252, last revised 9/17/2014
Page 2of2
Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted 01/09/17
CERTIFICATE OF COVERAGE NO. NCG 16 0012
FACILITY NAME Fred Smith Company - Wake Forest Plant
COUNTY Wake
PERSON COLLECTING SAMPLES Matthew James
LABORATORY ESC Lab Sciences Lab Cert. # ENV375
Comments on sample collection or analysis:
None
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Year 3 Period 1
SAMPLE PERIOD ❑ Jan -June [X] July -Dec
or ❑ Monthly', _ (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow Water Supply []SA
[X]Other C; NOW
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
Benchmarks =__>
-
-
100 mg/L or 50 mg/L
001
12/05/16
0.30
41.5
No discharge this period?Z
RECENED
JAN 17 2017
CENTRAL. FILES
DWR SECTION
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar 0&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks ==_>
_
-
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO [X]
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one copy of this DMR. includina all "No Discharae" reports. within 30 dovs of receipt of the lab results for at end of monitoring period
in the case of "No Discharoe" reports) to:
Division of Water Resources
Attn: DWR 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 roa erly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those per ons directly respq able for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am ayv e that there ar igni€icant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
Permit Date: 10/1/2014-9/31/2019
OqO-
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2
Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted 05/31/16
CERTIFICATE OF COVERAGE NO.jNCG16 0012 _
FACILITY NAME Fred Smith Company - Wake Forest Plant
COUNTY Wake
PERSON COLLECTING SAMPLES Matthew James
LABORATORY ESC Lab Sciences Lab Cert. #* ENV375
Comments on sample collection or analysis:
None
Part A:'Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Year 2 Period 2
SAMPLE PERIOD u Jan -June ❑ July -Dec
or ❑ Monthly'_ (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply [:]SA
RECEIVED [x]Other C; NSW
,SUN 0 6 2016 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL FILES
pWR SECTION
No discharge this period,
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
Benchmarks =_=>
-
-
100 mg/L or 50 mg/L
001
04/12/16
.0.49
18.3
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall:
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
'The total precipitation must'be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
° See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, N D, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
No discharge this period?z
Qutfall No.
Date Sample
Collected'
(mo/dd/yr)
.24-hour rainfall
amount,
Inches
Non -polar 0&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
-
-
15 mg/L
100 mg/L or 50 mg/L4
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO [X]
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an original and one coon of this DMR, including all "No Discharae" reports. within 30 days of receipt of the lab results tor at end of monitoring period
in the case of "No Discharae" reports) to:
Division of Water Resources
Attn: DWR 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 awpre that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Date)
Permit Date: 10/1/2014-9/31/2019
SWU-252, last revised 9/17/2014
Page 2 of 2
Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted 09/14/15
CERTIFICATE OF COVERAGE NO. NCG16 0012
FACILITY NAME Fred Smith Company - Wake Forest Plant
COUNTY Wake
PERSON COLLECTING SAMPLES Matthew James
LABORATORY ESC Lab Sciences Lab Cert. # ENV375
Comments on sample collection or analysis:
None
SAMPLE COLLECTION YEAR Year 2 Period 1
SAMPLE PERIOD ❑ Jan -June FX] July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
R❑Zero-flow ❑Water Supply ❑SA
ECEIVED [X]Other C; NSW
SEP 17 2015
CENTRAL FIL2S
Part A: Stormwater Benchmarks and Monitoring Results DWR SECTION
PLEASE REMEMBER TO SIGN ON THE REVERS%,;�,
Mumma
❑ No discharge this period?' r`
"I
Qutfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches;
Total Suspended Solids
Benchmarks =__>
-
-
100 mg/L or 50 mg/L
001
08/31 /15
1.37
77.7
ca-2
C
URIC
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. '
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
IncheS3
Non -polar 0&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEE DANCES IN A ROW FORTH E SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO [X1
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one coav of this DMR. including all "No Discharae" resorts. within 30 days of receipt of the lab results (or at end of monitorina period
in the case of "No Discharge" reports) to:
Division of Water Resources
Attn: DWR 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 erectly responss or gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware V,4f there a�si ican enalties jor_ rrtf inf€ g false information, including the possibility of fines and imprisonment for knowing violations."
re of Permittee)
Permit Date: 10/1/2014-9/31/2019
c7A7'11J_
(Date)
SWU-252, last revised 9/17/2014
Page 2 of 2
Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted 06/30/15
CERTIFICATE OF COVERAGE No. NCG16 0012
FACILITY NAME Fred Smith Company - Wake Forest Plant
COUNTY Wake
PERSON COLLECTING SAMPLES Matthew dames LABORATORY ESC Lab Sciences Lab Cert. # ENV3V5 __
Comments on sample collection or analysis:
None
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Year 1 Period 2
SAMPLE PERIOD ❑ Jan -June R July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
❑Zero -flow ❑Water supply ❑SA
RECEIVED [X]Otherc; NSW
JUL 06 ZU15 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL FILES
DWR SECTION
No discharge this period?2
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches;
Total Suspended Solids
Benchmarks
-
-
100 mg/L or 50 mg/!
001
06-19-15
2.63
95
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
'For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
° See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2
r9rI
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period??
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
IncheS3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks
15 mg/L
100 mg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
Note: if you report a sample value in excess of the benchmark, you must implement Tier I, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
+ A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO [X]
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an on final and one copy of this DMR including all "No Discharge" reports, within 30 days of receipt of the lab results jor at end of monitoring period
in the case of "No Discharge" reports) to:
Division of Water Resources
Attn: DWR 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 ectly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete,
m aawl there are sipc►i.f{cant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Sig ature 8f Permittee) (Date)
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 2 of 2
r
,M4 Semi-annual Stormwater Discharge Monitoring Report DMR
for North Carolina Da`MLR General Permit No. NCG160000 - Asphalt
Date submitted 01/26/15
CERTIFICATE OF COVERAGE No. NCG16 0012 SAMPLE COLLECTION YEAR Year 1 Period 1
FACILITY NAME Fred Smith Cornoanv - Wake Forest Plant SAMPLE PERIOD ❑ Jan -June [x] July -Dec
COUNTY Wake or ❑ Monthly' (month)
PERSON COLLECTING SAMPLES Matthew James DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
ESC Lab Sciences ENV375 ❑zero -flow ❑water Supply []SA
LABORATORY Lab Cert. #
Comments on sample collection or analysis: [X]Other C; NSW
None
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
❑ No discharge this period
r . ,�• ,at
rK1`�utfall NO�Rp
,r
3'
a�r�;t�q,',f
',DateSam le x
.`�
a
Collected`
a�(mo/dd/Yr7 .,,s
, 24 hour rain{all
its ij't-t
k �,:amount,� r� ,�t a 3.hc r
Inches a..p
+t^
Total Suspended Solidsir,
'8enciiinarks
00iri1g/L��orJ50mg/La;;#Ji
001
12-22-14
0.40
220
RECEIVED
FEB 2 5 2015
CENTRAL FILES
DWR SECTEON
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
!Vote: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month,
n No discharge this period?z
r
,
" 4 -45'�i
r '3�� }r
NY•+1 •
/� 5'.
.outfall�No
! IDate Sampler
s;.2 h ur rainfall 'f
!
1,r
i' ,;
Collected
-,R c,a
amount
Non olar 0&Grb EPA
,(� Trctr,
„(rrio/dd�yrj_.
a �,
nch
t ,� ,rs, ==yc �, ��
,w. TotaEjSuspend'ed 5o]ids'�
a
n�= L�Iesa t
.,�1664r(SGT HEM
Benchmarks
�. t 5:mg/L •a�,-c :a�
mg/L or�501mg��n�
.
k
.t �
,�� � �, d
.�,��+100 �.�
Footnotes from Part A also apply to this Part B
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO [X]
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lob results for at end of monitoring period
in the case o "No Discharge" reports) to:
Division of Water Resources
Attn: DWR 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 respon ible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware,5�?at there ign'sficant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee) Date)
Permit Date: 10/1/2014-9/31/2019
5WU-252, last revised 9/17/2014
Page 2 of 2
ti