NCG160189_MONITORING INFO_20140505

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
w (�� I V b) bI
DOC TYPE
❑ HISTORICAL FILE
U\MONITORING REPORTS
DOC DATE
❑ d y o 5 C
YYYYMMDD

RECEIVED
STORMWATER DISCHARGE OUTFALL (SDO) MAY 0 6 Z014
GENERAL PERMIT NO. NCG160000
DISCHARGE MONITORING REPORT (DMR) CENTRAL FILES
CERTIFICATE OF COVERAGE NO. NCG16000©_
DW0I9013 ?� Ig-
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 GAsranl PL-A4 i-r +16 2 COUNTY N oR-'rH r4+•'PTo R1
PERSON COLLECTING SAMPLES Scc7= PHONE NO. ( 8144-
CERTIFIED LABORATORY" 1"N M sx I . IN c- Lab # u
Lab #
Monitoring Requirements
Outfall
No.
Date
Sample Collected,
mo/dd/ r
Total Rainfall,
inches
00530
00400
00556
Total Suspended Solids, mg/I
pH,
Standard units
Total Petroleum Hydrocarbons, mg/I
EPA Method 1664 (SGT-HEM)
Benchmark
100
Within 6.0 - 9.0
15
-14
t•iZ
S•Z
l•1
LS•�
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, 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."
Cam-// " "✓�N�rf')
(Signs re of Permitte
+12-1II1+-
(Date)
SWU-252-051409
Page 1 of I

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GREENVILLE, N.C. 27835-7085 FAX [phone] _
ROSE BROTHERS (GASTON)
W. REID CLARKE
P.O. BOX 806
AHOSKIE ,NC 27910
PARAMETERS
PH (not to be used for reporting)
Total Suspended Residue, mg/l
TPH (1664A), mg/l
Stormwater Analysis Method
(#I, Grab) Date Analyst Code
7.6 04/09/14 TRR 450011B-00
8.2 04/10/14 CIVIC 2540D-97
<5.0 04/16/14 SF-1 EPA166411
ID#: 493
DATE COLLECTED: 04/08/14
DATE REPORTED : 04/16/14
REVIEWED BY: xlk

S CORiSIWATER DISCHARGE 1IOMTORING REPORT (D11IR)
Please Mai) Original And Chre Copy To h4ailing Address Below
GENN;RAL PERl141T NO. Hcroz0000
_ PmY R: Fa[iliry tnjprr,�atinra - - -
Certific Collected i Calendar Yce_r: (an nraplrr shall be r"rted wIND 31 days tellorring moattering period)
Certificate-OfCnerageNo. - NCGttt `01oJ_____
IraeilftyName CointyofFadiitr __6f(,�i
FacilltyCdnlict._ C'--° "": Name or Laboratory _E—vr r a I
Facility Contact Phone No. � Lab Ctrtift"(1cm if
(LSl o
ZI Za9- SI44_
rt ;
RerdlrlsE Stream
...Name _
PmtD: Storm Swrrf C%+o+ncterislics
Pert C: VfAicle Maifflmcmce Momoorime Rmuire.» w-nit
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�Kecetvlot Stteal7 1t' to �. Ta ...
Na. Kpam. ` r ¢ �t=-BtRtteadVs7.' p1f .
Total Event rreEipitatton (trrctses):
EverrtDamtioi fhours )_ -- Totat Erect Precipitatloo r1ndtes):
_ Evwt lhxatkm (hour's):
(if a acpacate stoner event is sampled)
Porn E: f:eroftcolioa �'{- j i .
"I certify, ender penalty of low that t is dactitirem curd atl designed atbchmarets were prepared aeda mp dfrertlau nr strptsvisioe in accordance wiat a
. systern ned to that qualifted perst,119 %'roperly gather and evaluate tha btformatiom submitted, $aced on inquiry of the
Or plrsoor who rAadi3 the m3' 4s t'Y person
MY 8E $stern, or ttrorc 04rc rs directly rxsponsblefor gathering the information, the information submitted is, to the pert
of ludinath edge hod tiel (;irtie,.&aufsle. art¢eemplete, I am aware [tact them are sigaificaat penalties for strbsdtting fake lnforroattoa,
including the pDultiility.iif finesaeil iailit3roarmmt for knosrletg Violafions."
` c r•'• (Signatare of Perroittee) {flxtc}
Attli: C.nf rat Fit es, 9�gN R, V.C. llivislon cC 1Satir Qualify, 16I7'.Stail Service Center, Raleigh, NC 27699-1617
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51"Uf(Ik]11'al'Elt LfSt_. AR(.E OISIVALL (SDO)
AiOKITORDNG REPORT
w GENERAL PERMIT NO. NCG160M0 . -
`� CERTTFTCATR OFCOVFRAGENO. NCGA O } n I
a rr l
F'ACMITY NAME it f114+ Z l Czc.S�era J
PERSON COLLECTINGSAMPLE(5) --Tet M
CERnF1ED LABORATOP.Y(5) E — Lab ii_L.O_
Lab S
Part A: Specific MonitoringReyuirements
0
m
Outfall
No.
Irate
Sample
Collected
5OD54
fatal ----'
Mnv
W530.
T'ota) -..
Srsoeuded
Solids
mWeldlyr
MG
UWB
F
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SA,NIPLP,S COLLEC-fED DARING CAI
(,rats mondirring mWt-sim" be recdvett
from the date the facility re¢clvta lire sarr
COUNTY � -�gscl.c
kR YEAR: 96 _
rDivislon no later than 36 days
�esattr from the laberatary.)
By this aq tem I certify that tltis.report fs acruruie
CMVIete to the best of ivy kYwwledge
Dues this fscihiy perform Vehicle Maintmance A<tiviti" using more than 55 gallons of now motor oil per month? -yes /ono
(ifyes, complete Part B)
Part B: Velir:e Maletemme k"tW
Ouifsll Date SODS
Ko. SaetP10 'rota
CaUcted .. �.
EVE'�"f' CHARACT6RI5rICS:
Date!
Total EvestPrecipltation (inches):
J�Wnt Duralion(hours): ZCo"_.
i
I�
1
(
f
(if r®re than one storm event was aamPkd)
Date
Total Event PreeipiiaRorr Cinches): —
Event Duration (hears):
- ZMle- o� t-,,,� -� "L
58,A'
ii'[ewit4a,tar' ,_
Ilsao
f ,UJ..t,a
L-kmCantFil
ginal and one copy to:
of Wake Quality
Filesil Semce Centex
NoTth Carolina 77699-1617
Fa:rn R•Jp-25:-07F-ip:
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136
M
STURPAIWATCR DISCHARGE OU'tVALL(SDO)
MONITORING RtWORT
GENERAL FERMIT NOL NCG I&NON SAMPtE5 CVLLlW-" DURING. CATIMAR YEAR. LaQS
CERMCATEOFOOVERAGF NO. NCG16 0101
(Tbd, r on*.Ag report shay be received In the Dhisba no llater tl-n 10 days tram
Z The daft the fwWtty receives t1w smpting results offath!-V�Qraluryl)
FACILJTYNAME Tjrv;j c' A—J.-Z'D axw" No;, M ION
PERSON COLLECTING SAMPLM) CcLiit PHONE NO. Z- -1 - qi P+4--
CERTIFIED LABORATORy(S)
b (SIGNATURE OF "AhUTTEROR DESIGNEE)
139 O&SIPa4ure, I cfttll� that *6 reporiiscarafe
Part A: Spcctft Nhidtaring Reqw1irenew cmpiete to the best of my knowledge
low
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a=
Ss
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Does the facility Pcvfbtm Vehicle WasuMnance Activities eang naoe dltan 55 gallom of nav motor oil per n1Gnth1_yosx1"
(if yes, complete Put 9)
PjlrtW*
I lid
STORM RVENTCHARACTERWICS;
Date I I- Z I
TO(a " of Pradpiftiron (hKbeS).
pmMuration (boors): - 1�
-rl
Mail Ortt" and one ropy to:
Division at Water Quality
Atua: Central Nimes
1617 Mail Service Center
Rakigh. Nanti f`uol im 27699-14517
Form MR 16
psge I of
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STORM WATER DISC—ARGE OUTF'AI L (SDOC) ,f
m MONITORING RRPORT .
� i
GENERAL PERMIT NO. NCGI60DW SAMnXS COLLECTED DURING CALLNDAR Yt?AW
CHRT'1F1C'ATT: OF COIr£RAGR T'O. NCG16 O 10 (This waitwing report welt be'received by the MY!" so_taur Wah 30 days -
a FACR..I l'Y NAAi_H .1� front the date fbe facility rerelvert the sampling rtesmhs from tk'e,tabtiratory.)
�nw�"L C�esl.-.-� COLFTYf'Y:•:.: .y�S��rilc,m: Q-j`t cam.. .". - -;
PERSON COLLPCTTNG SAAfPLF.(q w . Gr.a _
PAO1ViRN(i.fts�Z} - 1
CERTIFIED LAIiORATORY(S)_€nVtt�otal:. Lxb A Ld Lj'� l`� -<--,
(SIGNAT'URR OF PERMITFU OR DESIGNEE)
By this sgitafare, f eertify;tbat tkis report is aewralc
Part A: Spedtic Monitoring Regairesaeots conylete to the best al my knowledge' -
0
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in
9
p
f)trffax
No.
Da/c
Sample -Total
Colleded
SOM
ti9531:
. - .-:
Flow
Total .
k6pcaded
sma/d yr
MG
-
_
G off.
Q%S
Doss this Cacdih• perform Vchick Maintenance Activities vary more than 55 ga!loms of new motor oil perUKHMI?,_ ytsY._an
(if yes• compkte Part A)
STORM EWNT C HARACTERISTICS: '
(if mom that one s'tosmnxrn t = swFled)
Datr Ii-4_a�}- Date
Total Event Precipitation (iot9ses): 1, S Total Vvent Preeipltatiaa (kwhn):
Event Doration (hours)' 8 Event Daratioo (bows). -
T rwp . 5 8, 50
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STORhI WATT.R DMCRARGF OIITFALL (SfY))
MONITORING REMiRT
GFM..RAL PFRh1rT NO. NCG166K4
CFRTFFIC_kW OF Colt-FRAGENO. i'*CGI6
IT
FACILY NAME F l..1Z
PERGOLA l7(lF,t.Ist'i'RdG SAMPf.E(5) P,_-- y!',G P oLp
CERTIP lFD LABORATORY (S) Ex .� ott ins. 1 )TnZ Lab it
Lab r
Nrl A: Specific monitoring Requirements
SAMPI.ES COLLECTED DCIRTNG CALWDAR YEAR:'
(an samples calkRtd during a rtltrdar Tear shall be rtpotted nn later Lhaa
January ?t of the fallowing }ear)
COUN" r+lt
(SIGNATURE OF PERMTI'TEE OR DF.GH;NFE}
By the sigatart. I mrt)t'y &at the report is scasrate
rornpleo to the best of my knuwtedge
tT+Ca1!
Date y' s
50t3W
-
4p1
No
Sarnalt.
Tots1
Chenod .
P Flsrid
Grease
To'J
ed ..,.:.
ColleCrrl.. :.
RSosr .-s-
fh7TSp.
'"�;
-
.,...tw.v.r
twat
—A
_
Does this faculty pesfmm Vehicle Mvim Actvtacs usysg mat: than 55 gallons of sew OWAX oj per month? _yes A nO
Cif Im tvrnpictc Part B)
STORM EVENT CIIAIIACTERLMCS.
Date 10 - 29 - o.S
Team Event lamip3tstieo (inch"): _z. O --
E.tert Duratiov (6oursi _13—
(if more am am SWrm event was S=plCQ
Date
Total Event Precipilatine (incbes)'
Erect Duration (Roars): .
Pala I of 2
0
Tl
M" Orlgba) WA one copy to
Alta Cadrai Fi1a
DEHW
Division of Et> MIW Mgt.
P.O. Box 29535
Raldgh, )NC 276260535
Pvtn MR16

STORMW ATER DISCHARGE OUITALI- (SDO)
MONITORING REPORT
SAMPLES COLLECTED DURING CALENDAR YEAR: zaoZ
GENERALTIFICATEOFT OV R G16lNO.
CERTIF)CATE OF COVERAGE N0. NCG16 i O � ('liiv tendwrtug repast lx_.csnvea M the .I13Hsion m luer than 30 d"t hvm
.. -.
The date the facilHy rccei�cti the _ � !te• - �-l16oraM7'J .
FACILITY NAME ? I ram+ Z -':' •v
PF3WNODLLECnNGSAMPLE(S) '� Q.i G.lorl(a.. PIIOE Ii�:. - ' "
('L�R9'(FIIDLAH(1RA7'ORY(3)E••••:••••,..1= 4'Trc.
Lab p ESIGPPAit! , ¢PRMIf`(EKOR DESIGNEE)
RT tbarm t#st tltis:tr TWA is eceurate
cone *" to the hest of mp-
Pad A: Speeific Munkoring RegttintOwnu
jetgp, $S.�a
Does Ws facaity petfmm Vehicle Maiatcma Activities using mote than 55 gallons of new motor al Per MDAI _ yps xm
(if yes, Covtplex pan R)
STORM EVENT CRUSLAt.'TER(STICS:
DatejO
TOW Evert Precipitatfoo Cmcbev): Z�z
twat Draration (tmrs): __ !
9
Mal Or)glml "a one copy Lao-
Division of water Quality
Atm: Central Files -
-.16 i'1_ Nail Service Getter
-' ICaleig�t;`y:ortA'Otaaliaa 27699-1617
ram. MR 16
Page l of 2

STORMWATER DTSLM"GE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCGI60M SAKPLE5 COLIZCTF.D DUEkNG CALENDAR YSAI: Z Qa 1
CERTMCATE OF COVERAGE NO. NCG16 O 10 1 (Thisnruftertiq report siiaibe?adved by the Dividm w tKU"an10 days &'nn
am dare t6a facility rKvtver the rrsdits fro tfe bbo dory) .
FACILITYNAME
TBRSON COLLECTING S&?00jz(S) r,
CEITQ+IRD LASORATORY(S) ir-a I T h i C O
Lh i (9siGN1ATUM OF PRIYIITM OR DESIGNEE)
ly Oilk r4 to I 9-hmr i t ream acevrte
complete io the het of ay kanrkdf)P ..-.... .
Pat A: Si a 0 MenhorbW Rerpleemeafs
Oeftil Dale SM1! ii639 tilS% ` OWil
Na Siample Total Trial (Maw PH _
c"Ge ad Flo &Weaded Gteaae
Solids
nKmdfyr
MG W"
1- f5-02. O 3 L—I
Tamp � s.3
Don "s facility perform Vehicle hlaintemrco Ac6vitin thing more ahm 55 gallons of new motor oil per month'' _ yet
Cif yen oomoete Pan B) ' ..
STORM EVENT CHARACTERISTICS:
Date I • 14 - oZ.
Total Event Precipate/bn fiat):
Event Daratioa (how* 5
MtW t7rtiYaaf sari OS Wp9 ta.
Division of Weler Quality
' Atta: Central Mks_ -
1617 Maii SiMce Centel
Raieigh, Na}Ci�Ceicdiaa 276994617
Form MR16
Pap 1 of 7

08/08/2008 14:29 12525371405
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PAGE 09
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SiORMWATE DISC A RFPORFALLiSDO)
MON
m
Wa {ENERALPERMITNO.NCGi �Inl
CERTIFiC.ATF OF COVERAGE NO7.'iCG16
FACiL: TY NAME�-
pF.RSON COLLECTING SAMPLF.(S) T a
CERTIFIED L,-BORATORYIS)c4i i n • E vtw i¢ p Lab # _
Lab #
part A: Specific Monitoring -Requirements
— nu3dt) OOg00 ...:
to
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Date
Flow:
Chcmicat V
oxygen
Demand -
_..rt I v
SAMPLES COLLECTED DURING CALENDAR Y"retR: � _
(all samples collected during a calendnr1year,sisali b . reparfed no later than
January 31 of the following veer)
COUNTY
PHONE NO.
—
(SIGNATURE OF PERMiTTEE OR DESIGNEE)
By this signature, 1 certify that this report is accurate
complete to the best of my knowledge .
Oil attd Grease Total
gn+ded
Solids
Does this Facility perform Vehicle Maintenance Activities using mote dun 55 gallons of new motor oit per month? _ yes --Lao
- __i_.- van Al
STORM EVE`iT CHARACTERISTICS:
L-01 rf'1(e
Date 9 I
Total Event Preclpitatic (inches):
Event Duration (hours): 1 D
(if more than one storm "cut was sampled)
Date
Total Event Praipitatlon greehes):
Page 1 of 2
Mall Original and one copy to:
Aun: Central Flies
DEHNR
Division of Environtnerttal Mgt
P.O. Box 29535
Raleigh, NC 2i626-0535
Form MR 16