NCG160172_MONITORING INFO_20181211

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO. w
DOC TYPE ❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE ❑
YYYYM M D D

CERTIFICATE OF COVERAGE NO.
FACILITY NAMELY�u C
COUNTY
Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General PerInit No. NCG160000 - Asphalt
Date submitted i 1 151 Y
16C 1 %1
PERSON COLLECTING SAMPLES (_rL6 [5� H. Qt
LABORATORY +T{�1 Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR P/
SAMPLE PERIOD ❑Jan -Jun July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
��z Pother Q/-�S C
C
h'�nT�C 1
/2
010
SFCr/�L�S
❑ No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspended Solids
Benchmarks =__>
-
100 mg/L or 50 mg/L4
' 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, "<XXthey must be reported in the format, "<XX mg/L"/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 (lfsrhnrnp this narinrl?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/L4
Footnotes from Part A also apply to this Part B
NA
M41tii­T_---�Jr� /IICG
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: N A
Mail an original and one cony 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. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of
(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 emit No. NCG160000 - Asphalt
Date submitted
CERTIFICATE OF CO ERAGE NO/. �NCG16 0 I %
FACILITY NAME}',( ( OhG
COUNTY (AliS
PERSON COLLE ,NG SAMPLES QFf2L,6r A, CPbi7
LABORATORY i �I� Lab Cert. # J)0�
Comments on sample collection or analysis:
I
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR ' /
SAMPLE PERIOD ❑ Jan -June �uly-Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow [:]Watersupply [_]SA
Pother C GAS5 L
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/L°
' 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 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 Aln riivhn rna fAic n nri72
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
NA
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 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 ❑ NOYES ❑ NO ❑� �
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT?
REGIONAL OFFICE CONTACT NAME: A
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. 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: 10/1/2014-9/31/2019
A /f3
(D e)
SWU-252, last revised 9/17/2014
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General P rm't No. NCG160000 - Asphalt
CERTIFICATE OF COVERAGE NO. NCG16 G
FACILITY NAME Rs�eF CoNC� `>
COUNTY Cik@Y' S
PERSON COLLECTING SAMPLES C r S A GNIr7Y
LABORATORY f�: +Sr Lab Cert. q
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
Date submitted -7/G !9
SAMPLE COLLECTION YEAR-9CI8
SAMPLE PERIOD Jan -June ❑ July -Dec
or El Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply [:]SA
Other C-L ASS C
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
❑ No discharge this period?'
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Total Suspended Solids
Benchmarks =__>
or SO mg/L
(
(c 13 (e
1.
( M- L
G
RECEIVED
JUL 13 2018
CENTRAL FILES
D'J/R SECTION
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.
'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, 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

• •
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,
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
s
101
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 ANYONE OUTFALL? YES Q NO
IF YES, HAVE YOU CONTACTED THE DE LR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO
REGIONAL OFFICE CONTACT NAME: N �.�
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 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 Permittee)
Permit Date: 10/1/2014-9/31/2019
? /r /O,
4(Da e)
SWU-252, last revised 9/17/2014
Page 2 of 2

1/15/2018
t
Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 -Asphalt
Date submitted i I S g
CERTIFICATE OF COVERAGE NO. NCG16"<:--> L _-_O` SAMPLE COLLECTION YEAR�)VI_*7_—! L_ C e? 1
FACILITY NAME _� G-�7"—r� SAMPLE PERIOD Jan -June July -Dec
COUNTY C/i`t�jlu5 or Monthly' (rnonth)
PERSON COLLECTING SAMPLES G'h ;R O Cf lT 1 Y —_ DISCHARGING TO CLASS ❑ORW �HQW ❑Trout �PNA
LABORATORY �+�t �("� — —Lab Cert. p Lif% --_ �L`r �ero-flow [3Water Supply QSA
Comments on sample collection or analysis: J AN 2 4 2016 Other CLASS C ---_
--------------------
PLEASE REMEMBER TO SIGN ON THE REVERSE -)
Part A: StormwaterBenchmarks and Monitoring Results
pWRL FILES
SECTION
[:]No discharge this period?
outfall No.
Date Sa mple
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspended Solids
8enchman4s===�
-
-
100 mg/i
o
s s rn L-
I:;� ;017
/.0
h!a t4-btu
Monthly sampling (instead of semi-annual) most begin with the second consecutive benchmark exceedance for the same par arneter at the same outfall.
For sarnpling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkrnark 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 classificaticnswhere 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 mp,/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, Tier2, 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

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1 /151201 81f.:.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging>55 gal of new oil per month. 1\1
JQD Va7)4(0--E %lL�rw ory
No discharge thls period?
Outfall fb.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Non -polar 0 RG by EPA
1664 (SG T-HEM)
Total Suspended Solids
Be nchmarks===>
-
-
15 mg/T
100 mg/L of 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 Fier 3 responses. See General Permit text.
FOR PART si AND PART B MON IT Oft IN RESULTS:
A SI NGLF BE 1.1CHMARK EXCEEDANCE TR IGGEP.S TIER IRE OUIREMENTS.
• 2 E XCEE OAN CES I N A F:OW FOR T HE SAME PARANI ET E R Al T HESAh4 E 011 T FALL T RIG GE R HE R 2 R EOUI RE ME ITTS.
• IIEft 3: HASYOUR FACIUIY HAD 4 OR MORE BEhb_HMv .Rr. EiCE E DAN CES FOR THE SAME PARAIwIE T E F—;I AI•P! ONE VLHFALL' YES 0NO
IF YES, HAVE YOU CON TALI ED THE DE MLR REGIONAL OFFICE .AS RE 4UI RED BY THE PE P. f•.41T7 YES DN0
REGIONAL OFFICE CONTACT NArv1E: ________________________
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
YOII MAST SIGII TIIIS CERTIRCAHON FOR AFIY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachmentswere prepared under my dire�tion or supervision in .acordance with a system designed to
assure that qualified personnel property gather and evaluate the information submitted. Based on my inquiry of the person or personswhomanage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the bestof my knowledge and belief, true, accurate, and complete. I
am aware that these are significant penalliesforsubmitting false information, including the possibility of finesand impr'ignment for knowing•:iolatio its ."
Permittee)
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
Datesubmitted 0S/O�Oce
CCRTIFICAT'C OF COVERAGE No. NCG16C-�' L -7 a
FACILITY NAMI:
COUN,ry C '�'i/.�$t2u'S _
PE11$ONCOLLECTING SAMPLESCIiH�� Cf}ITl �
LA001WORY2:1 �!"/ \ ___ Lab Cen.!t
Comnlantw on r:nnlple collection or analysis:
part A: Stormwntat, Benchmarics and Monitoring Results
' 0 Ye-Li-
C -10
SAMPLE COLLECTION YEAR,TI_7_—' `_Li__ -1
SAMPLE PERIOD Jan -June July -Dec
or �Monthlyr (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout. E:]PNA
❑Zero -flow [-]water Supply [:]SA
�00ther C ____
PLEASE REMEMBER TO SIGN ON THE REVERSE )
lLrthll no
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount
r
Inches
Total Suspended Solids
D ux:hm mfis•••>
_
-
too mgfL
, C>
5 S . L
I�41? 9017
/,O
No f--Lv L"j
tso discbolge this period'
r Monthly sampling (instead of semi-ann(13l) Most begin with the second consecutive benchmark exceedance for the same parameter at the same OUtf311.
of s:unphllg periods with nU disc 1131 ge at any Single 0011311, you must still sUbmit this diScharlte monitoring report v: ith a checkmark here.
r I'h.- lUtal pre(ipilatioU nuct he rceotded Using data from an on -Site rain gauge. Unattended site, nrav be eligible for a •::aivet of the rain gauge retluirement.
,Set! General Permit test, table 3, identifying the especially sensitive receiving v:ater classificaticrrs v.-here the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Belos:• Detection Limit, BDL, <PQL, Non detect, ND, or other Similar non-
nunu:rical 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
tlutectlun limit, reporting limit, qu311titation limit, etc. in rng/L.
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.
Perrolt Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/1014
Page 1 of 2
f. ,

Yiz 3
hdz1od l
STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year 9016
Revised 911712014
General Permit No. NCG160000 DEC 2 8 2016
Certificate of Coverage No. NCG 16K4JI©�2F
CENTRAL FILES
This monitoring report summary is due to the DEMLR Regional Office no laterW MWThWr 1 of
each year.
Facility Name: r r 'H`r UE
County: Ct ARMRIR' u5
Phone Number: (74�)7 R o ' S
Total no. of SDOs monitored a
Part A. Outfall No. I— (use multiple sheets for multiple outfalls)
Is this 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 ❑
Outfall
Total Rainfall,
inches
00530
TSS, mglL
Benchmark
N/A
100
Date Sample Collected,
molddlyr
i
x �-
<�,
• '�v
I O
14
Yes ❑ No
Yes ❑ No X
Page I I

Part B. On -Site Vehicle Maintenance Outfall No. �' / r fiS "
Is this outfaIl currently in Tier 2 (monitored monthly)? r NO �(a 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
Total Rainfall,
inches
00530
00556
TSS, mg/L
Non-polar Oil &
Grease, mglL
Benchmark
N/A
501100
15
Date Sample Collected,
molddl ry
Man 1�1....
Z" f i� svi
V�.145W
Page 12

I
l
"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."
Mail Annual DMR Summary Reports to:
DEMLR Regional Office Contact Information:
Asheville Office ...... [phone]
Fayetteville Office ... [phone]
Mooresville Office ... [phone]
Raleigh Office ........ [phone]
Washington Office ...[phone]
Wilmington Office ... [phone]
Winston-Salem ...... [phone]
Swannanoa. NC 28778
[phone]
3800 Barrett Drive
Raleigh, NC 27609
[phone]
R'INST01-SALEAi REGIO�AC
OFFICE
585 Waughtown Street
Winston-Salem. NC 27107
[phone]
Jvstel Building 5mte r ii
Fayetteville, NC 28301-5043
[phone]
ASHINGTON,REGIONiCLQFF[
943 Washington Square Mall
Washineton. NC 27889
[phone]
610 Last Center Avenue/Suite 301
Mooresville. NC 28115
[phone]
R'IL \IINGTON RECION.CL OFFII
127 Cardinal Drive Lstension
Wilmington, NC 28405-2845
(910) 796-72 15

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year 6LO 16
Revised 911712014 RECEIVED
General Permit No. NCG160000 DEC 2 8 2016
Certificate of Coverage No. NCG 16P❑I r712❑ CENTRAL FILES
DWR SECTION
This monitoring report summary is due to the DEMLR Regional Office no later than November 1 of
each year.
Facility Name: .
County: l: Ckc�Sd�tyl��
Phone Number: 31� -7fae 0D-7S Total no. of SDOs monitored
I
Part A. Outfall No. (use multiple sheets for multiple outfalls)
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ Nog
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 �
Total Rainfall,
inches
00530
TSS, mglL
Benchmark
N/A
501100
Date Sample Collected,
molddlyr
AK
$OW
V
�w
l 30 i&
g' w
o
Page I I

Part B. On -Site Vehicle Maintenance Outfall No. 6'
i
Is this outfall currently in Tier 2 (monitored monthly)? No It lk IX f 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
Total Rainfall,
inches
00530
00556
TSS, mglL
Non-polar Oil &
Grease, mg/L
Benchmark
N/A
501100
15
Date Sample Collected,
mo/ddlyr
ar a rat
�4fNEI
tON
A t
T
t
Lw
Page 12

" 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
Date (2
Mail Annual DMR Summary Reports to:
DEMLR Regional Office Contact Information:
Asheville Office ...... [phone]
Fayetteville Office ... [phone]
Mooresville Office ... [phone]
Raleigh Office ........ [phone]
Washington Office ...[phone]
Wilmington Office ... [phone]
Winston-Salem ...... [phone]
ASHEVJLLE REGIONAL. OFFICE FAY EI 1 EVILLE REGIONAL OFFICEI MOORESVILLE REGIONAL OFFICE
2090 US Highway 70 225 Green Street 610 Last Center Avenue/Suite 301
Swannanoa, NC 28778 Systel Buildinu, Suite 714 Mooresville, NC 28115
i
[phone] Favetteville, NC 2830 1 -5043) [phone]
i
i RALEICIi REGIONAL OFFICE
1 3800 Barrett Drive
Raleigh, NC 27609
[phone]
WINSTON-SALEM REGIONAL`
OFFICE
585 Waughtown Street
Winston-Salem. NC 27107
[phone]
[phone]
WASHINGTON REGIONAL OFFICE
943 Washington Square Mall
Washinuton. INC 27889
[phone]
WILMINGTONREGIONAI OFFICE
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
13

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General PerTit No. NCG160000 - Asphalt
Date submitted
CERTIFICATE OF COVERAGE NO. NCG16n _I
FACILITY NAME N1W�s�ly�
COUNTY C / „/
PERSON COLLETING SAMPLESC A l t1
LABORATORY Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR;pb1 LG Y2a c,4
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
Zero -flow ❑Water Supply ❑SA
RECEIVED Pother cCq C
JUN 10 2016 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL FILES
DWR SECTION
❑ No discharge this period?'
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
as
Inches
Total Suspended Solids
Benchmarks===>
_
-
100mg/L
,3
N
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter ate same outfall.
' For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark�here?i
'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 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

M1
;
,�
,
,. �
�
-

Part B:
i
Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
P/A ❑ No discharge this period?2
Outfall No.
Date Sample
Collected'
a
(mo/dd/yr)
24-hour rainfall
amount,
Inches a
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
_
-
1S mg/L
100 mg/L or So mg/L
I
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 ANYONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED TH SREMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO El
REGIONAL OFFICE CONTACT NAME: �r\
Mail an oriainal and one coav 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 that there are significant pen AL fpr submitting false information, including the possibility of fines and imprisonment for knowing violations."
G -7/b
Date
Permit Date: 10/1/2014-9/31/2019 / SWU-252, last revised 9/17/2014
Page 2 of 2

_
_
y
i
�
�
..
•
�
1

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General er it No. NCG160000 - Asphalt
Date submitted C .0 1�Lo(S \/.
CERTIFICATE OF COVERAGE NO..NCG16 1 _�
FACILITY NAME
COUNTY Cq - -yam
PER36N COLLECTING SAMPLES R IF4C� t 1 fhMs
LABORATORY t�JM Lab Cert. q Lj Oa
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR v` — ttP4OD I
SAMPLE PERIOD ❑ Jan -June XJuly-Dec
or [:]monthly' (month)
DISCHARGING TO CLASS ❑ORW. ❑HQW [-]Trout❑PNA
❑Zero -flow ' ❑Water Supply ❑SA
;other CLfaSS C
RECEIVED
DEC 1 ( &,,, )
I'rn ,
PLEASE REMEMBER TO SIGN ON THE REVERSE -)
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
DWR S
24-hour rainfall
amount,
Inches 3
_ILCTIQr.,,
nd
To - ed Solids
Benchmarks
100 mg/ 50 mg/L
No discharge this period?'
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 simil*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: 10/1/2U14-9/31/2019 - SWU-2S2, last revised 9/17/2014
Page 1 of 2

Pat B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. / "/M
II
No discharge this period??
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
100mg/L or 50 mg/L
i
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 1, 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:
NO L/azf
Mad 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, ory
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."
(Signature of Permittee)
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 rmi No. NCG160000 - Asphalt
Date submitted 90 (5;_ /
I
CERTIFICATE OF COVERAGE NC )..NCG16c>L
FACILITY NAMEs—
COUNTY ( liS
PERs'6N COLLE NG SAMPLES lC ;-r/nM S .
LABORATORY � j�,lSfy\ _ Lab Cert. p L-10,m;L
Comments on sample collection or analysis
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 4 I �eklop
SAMPLE PERIOD ❑ Jan -June duly -Dec
or ❑ Monthly' (month)
DISCHARGING TOCLA,SS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow � ❑Water Supply ❑SA
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 SO mg/L
o discharge this period?z
' 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 similaYnon-
numerical format. When results are below the applicable limits, they must be reported in the format, "<XXthey must be reported in the format, mg/L/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. KJA
I ANo 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
IOOmg/L or 50 mg/L
Footnotes from Part A also apply to this Part B
No
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 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 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.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee) (Date)
SWU-252, last revised 9/17/2014
Perini[ Date: 10/1/2014-9/31/2019
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted IS
CERTIFICATE OF COVERAGE ENNo. NCG160 —1_
FACILITY NAME t��GAG�"� . C�)OV.Y��2\ [—All
PERSON COLLECTING SAMPLES Ut
LABORATORY ?;2-I Sm Lab Cert. p
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 'Q0 I5—
SAMPLE PERIODXan-June ❑ July -Dec
-- ----or- [:]Monthly'--- ------ - -/month/ -
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
R�q���.® ❑Zero -flow ❑Water Supply ❑SA
V �' ❑Other CI-5S C
AN 18 2015
FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4
DWR SECTION
ryrNo discharge this period?'
Outfall No.
Date Sample
Collected r
(mo/dd/yr)
24-hour rainfall
amount,
3
Inches
Total Suspended Solids
Benchmarks ===>
_
-
100 mg/L or 50 mg/L
—�—!
3
L
Nc� rl ow
-3
' 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.
3 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 mR/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: If you report o sample volue 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

i
Part-B: Vehicle"Maintenance Area Monitoring Results: on-fy for facilities averaging > 55 gal o of ew oil per
Footnotes from Part A also apply to this Part B
No discharge this period?z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
n
Inches
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
_
-
15 mg/L - - --
- 100 mg/L or 50 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.
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 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 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."
(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 �" 15
CERTIFICATE OF COVERAGE NO. NCG161, —I ' /
FACILITY t/t-p� ME2,\
COUNTY �1�/�Zt�s
PERSON COLLECTING SAMPLES L8r C`H I TrY
LABORATORY P P.I SVI Lab Cert. tf c�
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR
SAMPLE PERIODLA7iJan-June [] July -Dec
or Monthly' Y (rnan th)
DISCHARGING TO CLASS DORW [_JHQW UTrout [:]PNA
❑Zero -flow Water Supply [:]SA
❑Other C/-J3,55 C
PLEASE REMEMBER TO SIGN ON THE REVERSE -i
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
:-Suspended Solids
Benchmarks =__>
_
-
g/L or So mg/L
rylr i
No discharge this periods
Monthly Sampling (instead of semiannual) most 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 moniloring report with a checkmark here.
the total precipitation must be recorded using data Isom an on -site rain gauge. Unattended sites may he 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 exam 1LI e, do not report Below Detection Limit, BDI., <PQL, Non -detect., ND, or other similar non-
nutnericaLformat. When -results are-below-the-applicableiirnit s,-they-must-be reported -in -the format, ' <XX rang/L", where XX is the numerical value of the
detection limit, reporting limil, quantitation Gmit, etcin 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 Dale. 10/l/2014-9/31/2019
SWU-252, last revised 9/II/2014

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
NIA
Footnotes from Part <
No ditch h _1'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Non -polar O&G by EPA
1664 (SGT-HEM)
orge t is perod.
Total Suspended Solids
Benchmarks
15 mg/L
100 mg/L or 50 mg/L
i
NNy to uus tart 6
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 AND PART B MONITORING RESUCI '
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCE EDANCES IN A ROW FOR THE SAME PARAMETER Al --I M SAME OUT-ALI. TRIGGER TIER 2 REQUIREMENTS.
TIER 3: HAS YOUR FACILI IY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER Al ANY ONE OUTFALL' YES [:1 NO E]
IF YES, HAVE YOU CONTACTED THE DEn41 R REGIONAL. OFFICE Al; REQUIRED BY THE PERMIT' YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail on original and one copy of this DMR including all "No Discharge„ reports, within 30 days o/receipt of the lob results /or at end o/monitoring in the case of "No Discharge" reports) to: period
Division of Water Resources
All,': DWR Central files
1617 Mail Service Center
Ra Leigh, North Carolina 27699-1617
YOU MUST SIGN THIS C_ER_1l FICATIO_N FOR _ANY IN FOR MATION REPORTED:
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 g rthering the information,-the.infonnation. submitted.is_to.the bestofmy knowledge and belief, true, accurate; and complete- 1
am aware that there are significant penalties lot submitting false information, including The possibility of fines and imprisonmem for knowing violations."
_ I
(Signature of PermGee
Permit Date: 10/l/2014-9/31/2019
(Date)
SWU-252, last revised 9/17/2014

STORNINVATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG1600(I0
DISCHARGE MONITORING REPORT (DMR)
CERTIFICA'rE OF COVIiRAGIi NO. NCGI65F?I[jj)]�
FACILITY NAME i�
PERSON COLLECTING SANIPLIS Q(tES 1 f
CERTIFIED LABORATORY m c:M _ Lab #
Lab Jr
Monitoring Requirements
SANIPLES COLLECTED DURING CALENDAR VEAR: 1 ECEIVED
(Phis monitoring report is due at [he Division no later than 30 days fro 'P6 2015
the laeility receives the sampling resalts Gom the Iabormrny.)
COUNTY —
PHONE, NO.
n1nro r"L FILES
Outfall
No.
Date
le Collected,
Esao/dd/vr
Total Rainfall,
inches
00530
00400
00556
Total Suspended Solids, in
pH,
Standard units
Total Petroleum Hydrocarbons, nrg/1
EPA Method 1664 (SGT-HENU
Benchmark
-
t00
Within 6.0-9.0
15
It a value is in excess otthe henchmark, or uuuide the benchmark range (for pl l)- you mist ingtlemcnt the Tin I or Tict 2 responses in the General I'crurii.
Mail original and one copy to:
Division ut Water Quality
Atuc Central Files
1617 Mail Service (:enter
Raleigh, North C:aolina 27699-1617
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