NCG140001_MONITORING INFO_20190430

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE, HISTORICAL FILE
MONITORING REPORTS
DOC DATE \�) 0133 U
YYYYM M DD

EXCEEDANCE or TIER 2 DISCHARGE MONITORING REPORT
- STORMWATER
11 SUBMIT TO REGIONAL OFFICE* I
General Permit No. NCG140000
`Use this form if any stormwater samples have EXCEEDED A BENCHMARK or if the facility is in TIER 2 MONITORING for any parameter.
Send sample results to the DEMLR Regional Office within 30 days of receipt from the laboratory.
Certificate of Coverage No. NCG140001
Facility Name: Thomas Concrete of Carolina — Raleigh Plant Sample Collection Period: Period 10 Period 2 ❑ Calendar Year 2019
County: Wake For Monthly Monitoring: Month: April
Phone Number: 919-828-4403 Person Collecting Samples: Duncklee & Dunham, Lily Walker
Certified Laboratory: ESC Lab # ENV 375
Lab #
Has this facility had 4 or more benchmark exceedances for any single parameter, at any one SW discharge outfall (SDO)? Yes ® No ❑
Have you contacted the Regional Office? Yes ® No ❑
Whom at the Region did you speak with? Thad Valentine
Stormwater Monitorina Reauirements
Outfall
No.
Date Sample
Collected
Total
Rainfall
Is this SDO in
Tier 2?
Does this SDO
include Vehicle
Maintenance
Activities (VMA)?
Total
Suspended
Solids (TSS),
mg/I
pH,
SU
Non -polar O&G
(EPA Method 1664
(SGT-HEM)), mg/I
(VMA)
lf.ppIicebM
New Motor Oil
Usage (gal/mo.)
H BppllcaDle
sro. y mac, t 8
x
e }n'�
"'�+
Imo/dd/yr�
"or "NO'FL<OW'
a l.S :.
V inches';
Y/N
Y/N
100
50 )ORW. HOW. Tr, PNA)
6.0-9.0
15
>55 gagM. average
regobee T68 aW Non.poiW
O&G monilorlrg
001
04/30/19
---
Y
N
NO DISCHARGE
N/A
N/A
Permit Date 8/1/2017 — 6/30/2022 Last Revised 8-22-2017
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Certificate of Coverage No. NCG140001
CERTIFICATION
"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." [Required by 40 CFR §122.22]
Signs
Date
Mail Benchmark Exceedance/Tier 2 DMR to Your DEMLR Regional Office Land Quality Section:
ASHEVILLE REGIONAL OFFICE
FAYETTEVILLE REGIONAL OFFICE
2090 US Highway 70
225 Green Street
Swannanoa, NC 28778
Systel Building Suite 714
[phone]
Fayetteville, NC 28301-5043
[phone]
RALEIGH REGIONAL OFFICE
WASHING"CON REGIONAL OFFICE
3800 Barrett Drive
943 Washington Square Mall
Raleigh, NC 27609
Washington, NC 27889
[phone]
[phone]
WINSTON-SALEM REGIONAL CENTRAL OFFICE
OFFICE Questions for The Central Office
450 Hanes Mill Road, Suite 300
Winston-Salem, NC 2-1 Stormwater Permitting Program?
[phone] [phone]
Permit Date 8l1/2017 — 6/30/2022
MOORESVILLE REGIONAL OFFICE
610 East Center Avenue/Suite 301
Mooresville, NC 28115
[phone]
WILMINGTON REGIONAL OFFICE
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
Last Revised 8-22-2017
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