NCG160148_MONITORING INFO_20180611

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO. Jv L/ b
DOC TYPE ❑ HISTORICAL FILE
�-B MONITORING REPORTS
DOC DATE ❑ O I b D ��
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submittecK--Ga6/8
CERTIFICATE OF COVERAGE NO. NCG16 D /
FACILITY
COUNTY
PERSON
LABORAI
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR o?D/S
tom' SAMPLE PERIOD Jan -June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow [:]Watersupply ❑SA
RECEIVED ®Other
JUN 11 2018 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL FILES
DWR SECTION
No discharge this period?Z
OutfellNo
- Date Sample24
_ Collected'
(mo/dd/yr)
hour'.rainfall
amount
--' —,
Inches -
= -"-
TotalSuspended Solids
Benchmarks =__> .:
-�::_ '- - - -
_ - --
100 mg/L or 50 mg/l.
s-a -ateCZ
1,2.7 .>,
' 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.
'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, 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.
n No discharge this neriod;12
Outfall No
.* -
Date Sample
Collected - -
.-...(mo/dd/yr)
24 hour rainfall
amount ��
_ , _:Iri[hes' -:=
Non polar O&G by,EPA
_1664(SGT'-HEM)
Total Suspended
Benchmarks >ey-
15 mg/L "
A00 mg/Cv r50 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, Tier2, 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 ❑
IF YES, HAVE YOU CONTACTED THE DEM LR 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 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
"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 awar at `th re are significant penalties nor submitting false.information, including the possibility of fines and imprisonment for knowing violations."
Permittee)
T (Date)
Permit Date: 10/1/2014-9/31/2019
SWU-252, last revised 9/17/2014
Page 2 of 2

:E Semi-annual
for North Carolina DEMLR General Permit No. NCG
Date submitted ,2616
CERTIFICATE OF COVERAGE NO. NCG16 O 1 ,_
FACILITY NAME ! .X tkko1 F%/ Pen /r'id.3 f%sphyaw'
COUNTY ah&!2260W
PERSON COLLECTING SAMPLES /YF//lam �Ji�sf�4tlX
LABORATORY Afle,?A6,4-G Lab Cert. # 6/
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
em
SAMPLE COLLECTION YEAR o26 /A
SAMPLE PERIOD [)Jan -June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
❑Zero -flow [—]Watersupply [:]SA
Other
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
❑ No discharge this period?2
_ -
Outfall No.
Date Sample
_-
Collected',
(mo/dd/yr)
.14-hour rainfall ---
- -
amount;:-
Inches'
-
Total Suspended Solids
Benchmarks===> -
_
- -
-'100 mg/L or 50,irig/L --
—20. 20 /4
5'
/St/
RECEIVE?
AUG G I 11016
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 Far 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.
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, Nan -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-2S2, last revised 9/17/2014
Page 1 of 2

Part B:Aehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?'
-Outfall No.
-I
-
Date Sample:._
Co - r-
llected
- _ .
- (mo/ d/y - .
24hourramfall
amam ount,
_ l 3
in . _ _ .
Non polarO&G by EPA
= - - -
,. --. 1664. (SGT HEM) _==
- Tot- ---endedSolids
. _ -
Benchmarks.===>
-
15 mg/L
100; mg&or50 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 OUTFALLTRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMAR E EEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NOO
IF YES, HAVE YOU CONTACTED THE DEMLR REGION REQUIRED REQUIRED BY THE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME: JJ//
Mail an original and one copy of this DMR including all 'No Discharge" reports within 30 days of receipt of the lob 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 that t e significant penalties7for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of P ittee) (Date)
Permit :10/l/2014-9/31/2019
SWU-252, last revised 9/17/2014
Page 2 of 2

i-annual
Report (DM
for North Carolina DEMLR General
s-
•-� Date submitted
J
CERTIFICATE OF COVERAGE NO. NCG116 0
FACILITY NAME_S,77N047Z%1 c ��/W.P. i
COUNTY
PERSON COLLECTING SAMPLES
LABORATORY /)I IdLab Cert. It >/
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
rmit No. NCG160000 - Asphalt
SAMPLE COLLECTION YEAR �?O/ S
SAMPLE PERIOD ❑ Jan -June July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
[.Other
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
No discharge this period?z
Outfall No.
Date Sample
r
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspenced Solids
;Benchmarks -> -
_._...:
- . -:.
:-� .100 mg/L oi;50 mg/L-.=,'.
a -3, aors
aZ L<
' 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.
'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, 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?z
Date "Sample 24 hour;ramfall
Outfall No —
_ Collected', amiiuntpolar.;0&G by:EPA .. ' -
s -_ -- Total Suspended Solids
.:(mo/dd/yr) __ :Inches ._;' '_1664'_(SGT HEM)_ .,..,.
♦Benchmarks.. is.:r^B/4 .. r .100 mg/L or50 mg/L. .
Footnotes tram 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 1, or Tier, 3 responses. See General Permit text.
FOR PART 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 ❑
IF YES, HAVE YOU CONTACTED THE DEMUR 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 ly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am awa at there re significant penalties f f submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature Permittee) - (Date)
Per it Date: 10/1/2014-9/31/2019 - SWU-252, last revised 9/17/2014
�� Page 2 of 2

Semi-annual Stormwater Dischi
for North Carolina DEMLR General
Date submitted
CERTIFICATE OF COVERAGE NO. NCG16_Q / g
FACILITY NAME S,T, D1/DOjZri1/ dve.P
COUNTY r ift?Tf/*i�1
PERSON COLLECTING SAMPLES
LABORATORY- A /d/?OBA,f Lab Cert. # >/
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
f�
Re
!rmit No. NCG160000 - Asphalt
-/n —fin iC
SAMPLE COLLECTION YEAR o2o/ S
SAMPLE PERIOD ❑ Jan -June July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
w��VGgI ❑Zero -flow []Watersupply ❑SA
V 6D Other
V 16 2015
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL FILES
DWR SECTION
-, ate Sample - ._24=hourrainfall
OutfalbNo , Collected' amount;
Totalsuspended sohds,
..lather ,..
Benchmarks.- - --100 mg/L.or SO mg/Lv-+
I
Vo discharge this period?z
Monthly sampling (instead or 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.
Q 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 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.
nAin rlicrhnrno thic norinrl JZ
�.�,
-
Date Sample
24 hour rainfall'
`
;
- OutfalLNo
1
Collected
amount
�
Non O&G by EPA
_
'
-_
polar
TotaLSuspended Solids
a
- „
1664_(SGT HEM)._,._
..Y,�_
;Benthmarksl300: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 musi,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 ❑
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 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 ly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am awa at there Ire significant penalties fo submitting false information, including the possibility of fines and imprisonment for knowing_ violations."
/
(Signatur f�Permittee)
Rer it�10/1/2014-9/31/2019
-2,16
(Date)
i
SWU-252, last revised 9/17/2014
Page 2 of 2

4,` Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted 7—/3-e2o/,S
CERTIFICATE OF COVERAGE NO. NCG16¢ /
FACILITY NAME S. %(AJQf)7XAJ fc25L /�/OG� J7SrH73GT
COUNTY Cf�l�/�i4,✓1
PERSON COLLECTING SAMPLES 4t,0_X
LABORATORY Lab Cert. q 1/
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR o?O/S
SAMPLE PERIOD Jan -June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply [:]SA
Other
RECEIVED
JUL 2 4 2015
CENTRAL FILES
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
❑ No discharge this period?Z
Clutfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Total Suspended Solids
Benchmarks =__>
_
-
100 mg/L or 50 mg/L
G- S-iS
/
y s�.V►
_2
S
RECEIVED
JUL 2 4 20115
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.
Q 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?z
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 ❑
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 jirectly res nsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware t there are nificant penalties for submi ng false information, including the possibility of fines and imprisonment for knowing violations."
4" 7-/3 -o2oia
(Signature of rmittee) (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 /6-,�274f4
CERTIFICATE OF COVERAGE NO. NCG16 6 L g
FACILITY NAME
COUNTY /,*;
PERSON COLLECTING SAMPLES _i1P. /0-.n
LABORATORY .565 Lab Cart. ii
Comments on sample collection or analysis-.
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR �/T
SAMPLE PERIOD ❑ Jan -June July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW .❑Trout ❑PNA
❑Zero -flow ❑Water Supply [:]SA
[Other
PLEASE REMEMBER TO SIGN ON THE REVERSE -)
❑ No discharge this period?z
'-L
'
Outfall No
Y_
Date Sample
Collected r
= a
_ `24 hour rainfall-
amount'
x-=
Total Susperided solidi
-
=eenchmorks
RECEIVED
NOV 1 3.2014
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.
1 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, 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:
�`-
Date Sample
Outfall No -y
-
Collected
amount
=Non polah0&G by EPA_
' - '
_ ..,_,...
mo/dd/yr)" '..-1664.(SGT
-^-
HEM)
Total Suspended Solids ;
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 PARTAAND 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. r�
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER ATAN ONE OUTFALL? YES ❑ NO glj(
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT?' YES ❑ NOT
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 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 directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and.complete.
am aware th are significant penal 'es for submitting false information, including the possibility of fines and imprisonment for knowing violations."
71
(Date)
10/1/2014-9/31/2019 - - SWU-252, last revised 9/17/2014
Page 2 of 2

STORM WATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG160000
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE OF COVERAGE NO. NCG1451 !❑©® SAMPLES COLLECTED DURING CALENDAR YEAR:
(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 � 7—Wbo7 j /� R, ., =- ��T COUNTY C- M4Tl�
PERSON COLLECTING SAMPLES NtC'K 1V?Z0A//h.0 PHONE NO. (..S2-)
CERTIFIED LABORATORY S Lab # '->✓S/
Monitoring Requirements
Outfallz
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r 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.
Mail original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, Noah Carolina 27699-1617
YOU MUST SIGN THIS
FOR ANY INFORMATION REPORTED:
RcUtIVED
SEP g 5 2014
CEp O/Q
"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 t"re significant penalties PH submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
9- a,-adlL
(Date)
SWU-253-051409
Page 1 of 1

STORMWATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG160000
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE OF COVERAGE NO. NCG16© /❑©® SAMPLES COLLECTED DURING CALENDAR YEAR:
(This monitoring report is due at the Division ho later than 30 days from the date
(�
the facility receives the sampling results from the laboratory.)
FACILITY NAME UI�TA/ J�oa R- , /�SP 4,7- COUNTY C' air
PERSON COLLECTING SAMPLES /! g"AIAL.Z> PHONE NO. (a52
rKCK1
CERTIFIED LABORATORY Lab # S1
Monitoring Requirements
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Np
o14
O o
AID 2 S
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.
Mail original and one copy to:
Division of Water Quality
Attu: 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 th4cegre significant penaltlesffir submitting false information, including the possibility of fines and imprisonment for knowing violations.,
9-
(Date)
SWU-253-051409
Page 1 of 1