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Home My WebLink AboutNCG210418_MONITORING INFO_20151229STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. /v O qN DOC TYPE ❑HISTORICAL FILE f9 MONITORING REPORTS DOC DATE YYYYMMDD STORMWATER DISCHARGE OUTFALL (SDO) M I:s MONITORING REPORT Permit Number: NCS or SAMPLES COLLECTED DURING CALENDAR YEAR: Certificate of Coverage Number: NCG a nyl (This monitoring report shall be received by the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) FACILITY NAME 459AV6-9 W rnD -ULl ALT-S TAL PERSON COLLECTINGSAMPLE(S) lSN.9V151C CERTIFIED LABORATORY(S) Z LLaab # l# Part A: Specific Monitoring Requirements DEC 2 $ CUI Ln,A.AL Jz1, A � COUNTY PQWMY PHONE, NO. ('7D�J) 9 7F3 GIP1 (SIGNATURE OF PERMITTEE OR DESIGNEE) By this signature, I certify that this report is accurate complete to the best of my knowledge. 4Sample Collected Total 1app.) 1 I Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no (if yes, complete Part B) Part B: Vehicle Maintenance Activity Monito ing Requirement Outfall Date 50050 06556 00530 00400 No. Sample Collected Total Flow (if applicable) Total Rainfall Oil & Grease (if appl.) Non -polar O&G/TPH (Method 1664 SGT-HEM), if appl. Total Suspended Solids pH New Motor Oil Usage molddl r MG inches n m Units al/mo rQ e Form SWU-246-062310 Page i of 2 S .ORM &IVENT CHARACTERISTICS: Date 11-9-1� Total Event Precipitation (inches): i r Event Duration (hours): _ 3_Pr< (only if applicable —see permit.) (if more than one storm event was sampled) Date Total Event Precipitation (inches): Event Duration (hours): (only if applicable — see permit.) Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 "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." y (Signature of Permittee) (Date) Form SWU-246-062310 Page 2 of 2 Client' 6A6 txr wood P oda-03 —1-11 STATESVILLEANALYTICAL 122 Court Street • P.O. Box 22'8. Addfess: -�` Statesville, NC 28687 (704)872-4647. ' Contact Person: 1 I �L /1 Phone #�)V4 `,�75- 7;91 FAX _530q 1 Chain of Chain Custody Record PO # Requisitioned by: (Time Date) Customer Sample IN Lab-lD tk Time Sampled (Grab Only) Date Sampled (Grab Only) a Matrix parameters requested for analysis 51^0 w M goo aft X i55 x PH -7t 38 OF 0(4 -CC( 11 a I 150 F1c,w fin o"Nq x Co x x PI4 '' -7, 23 6'5� a oT {{ r oef'), 0 3 OWD Pm x T55' 00W ID CPm 01,-1y , . eoD Relinquished by: ( Time ii: l0. amL m Date r 1 5 Sampled by: �uA� Received by: � Time y • 119 am, pm Date �(.r Trans ported b : p Y Relinquished by: Time am, pm Date Holding times met: Received by: Time am, pm; Date Compliance work: Composite Sampling #1: Time begin am, pm Date Non-compliance work: Time end am, pm Date _I I_ Lab Comments: Composite Sampling #2: Time begin am, pm Date I_I Time end am, pm Date Analytical Results Shaver Wood Products 14440 Statesville Blvd Cleveland, NC 27013 Receive Date: 11/09/2015 Reported, 11 /18/2015 For: Stormwater Comments: Sample Number Parameter Sample ID Result Unit Method 151109-15-01 Oil and Grease Outfall#1 151109-15-01 TSS Outfall#1 151109-15-02 Chemical Oxygen Outfall#2 Demand 151109-15-02 TSS Outfall#2 151109-15-03 Chemical Oxygen Outfall#3 Demand 151109-15-03 TSS Outfall#3 Respectfully submitted, Dena Myers NC Cert. #440, NCDW Cert #37755, EPA #NC00909 10 1, I1 Lf Analyzed _Analyst <5.3 mg/L EPA1664RevB 11111712015 MD 86 mg/L SM2540D-1997 11/10/2015 WL 373 mg/L HACH8000 11/12/2015 CL 27 mg/L SM254OD-1997 11/10/2015 WL 361 mg/L HACH8000 11/12/2015 CI- 58 mg/L SM2540D-1997 11/10/2015 WL LS NOV 23 2015 PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 1 of 2 Condition of Receipt Temp on Sample Number 151109-15-01 Arrival: 2 Parameter Schedule: Oil and Grease Hydrochloric Acid Received on Ice Chemicals in containers, lab Parameter Schedule: TSS Received on Ice Temp on Sample Number 151109-15-02 Arrival: 2 Parameter Schedule: TSS Received on Ice Parameter Schedule: Chemical Oxygen Demand Sulfuric Acid Received on Ice Chemicals in containers, lab Temp on Sample Number 151109-15-03 Arrival: 2 Parameter Schedule: TSS Received on Ice Parameter Schedule: Chemical Oxygen Demand Sulfuric Acid Received on Ice Chemicals in containers, lab PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 2of2 STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM GENERAL PERMIT NO. NCG140000 CERTIFICATE OF COVERAGE NO. NCG140418 SAMPLE COLLECTION YEAR: 2015 FACILITY NAME: Thomas Concrete of Carolina-Knightdale Plant_ SAMPLING PERIOD: ❑ July -December PERSON COLLECTING SAMPLES Susan Bostian COUNTY Wake CERTIFIED LABORATORY ESC Lab # ENV 375 PHONE NO. (919) 217-2946 Lab # �. ADD TO LISTSERVE? []YES. ®NO EMAIL: OPTIONAL INFO: DISCHARGING TO CLASS: ®SA ❑HQW Part A: Stormwater Monitoring Requirements ® January -June ❑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 Sampling' - - 6-9' 1Dpz,3 - - - - 001 No Discharge 0 N Im 0Vj m z t 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/I. ° For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge. 0 M m 0 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 (mo/dd/Yr)1 pH (Standard Units) TPH using method 1664ASGT--HEM (mg/L) Total Suspended Solids (mg/L) Event Duration (minutes) Total Rainfall a (in) New Motor Oil Usage (gal/month) In Tier 2 Monthly Monitoring? (Y/n) q of Months in Tier 2 Sampling' 6-9' 15' 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 Ori inai 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. am aware that re are Qsignificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." 7/31/2015 (Signature of Permittee) U(Date) Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11 Page 2 of 2