NCG190094_MONITORING INFO_20160202

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v �� I b o
DOC TYPE
❑ HISTORICAL FILE
f MONITORING REPORTS
DOC DATE
❑ �,o ) b -0 a
YYYYM M D D

ALL (SDO)
GENERAL PERMIT NO. NCG190000
DISCHARGE MONITORING REPORT MUM
CERTIFICATE OF COVERAGE (COC) NO.: NCG1951D®Q
FACILITY NAME: C4k31T'S.S �l:c.°�� 1'AQ.^tom
SAMPLE COLLECTION AME: il�4r.M
CERTIFIED LABORATORY: brU C%) fU N tkP..t. I��r Lab # 10
Lab #
Part A: Specific Monitorine Reauirements
RECE V EMIPLE COLLECTION CALENDAR YEAR: U 17
(This monitoring report is due at the Division no later than 30 days from
FEB tD&a 0e he facility receives the sampling results from the laboratory.)
CENTRAL FILiFkaLITY COUNTY: 1 I'N`1
DWR SECTION
PHONENO.: SZ -iC*tC,-CC.�1
Outfall
No.
Sample
Collection Date,
mo/do,r
Total Rainfall,
inches
00530
TPRbyanthud
1664 tSGT-HEAD
01119
01104
01094
01.114-
Total Suspended
Solids, m /L
Non -Polar Oil &
Grease, mg/L
Copper-'', mg/L
Aluminum', mg/L
Zinc ' ,mg/L
Lead", mg/L
Freshwater
(Saltwater)
0enchmnrks
-
-
100
15
0.010
(0.005)
0.75
0.126
(0.095)
0.075
(0.220)
J�
t2-)$-/T
1 t1211%=J'tC.7I—
if a value is in excess of the benchmark. you must implement the Tier 1 or Tier 2 responses in the General Permit.
' Total recoverable metal.
`These benchmarks are water hardness dependant. Values shown based on -a hardness of 50 mg/L.
Solvent Management Plan Certification:
Mail original and one copy to: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permitrequirement for
Division.of Water Resources managing solvents. I certi& that to the best of my knowledge and belief, no leak, spill, or dumping of concentrated solvents
.Attn: Central Files into the stormwater or onto areas which are exposed to rainfall or stormwater nmoffhas occurred since filing the last discharge
1617 Mail Service Center monitoring report. I further certify that this facility is implementing mire provisions of the Solvent Management Plan
Raleigh. North Carolina 27699-1617 d included in the Stormwater Pollution Prevention Plan." /
6
(Signature of Permittee) (Date)
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 fine nd mprisonment for knowing violations." I
(Signature ofjPefrnittee) (Date)
Permit Date: 6/022015-5/31 /2020 SSVU-253-060515
Page I of 1

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR) CZ-)
Calendar Year .ld
General Permit No. NCG190000
Certificate of Coverage No. NCG19©©®�❑
This monitoring report summary is due to the DWO Regional Office no later than 30 days from the date
the facility receives laboratory sampling results from the final sample of the calendar year.
Facility Name: .
County: _7
Phone Number:
v we 1KA-,ei o"-3--
Total no. of SDOs
itored
i
�r
Outfall No. �D=3
Is this outfall currently In Tier 2 (monitored monthly)? Yes ❑ No (]�
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No a.r
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 DWQ to reduce monitoring frequency ❑ !
Other
• .
•
• • •
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S W U-250NCG 19-092309
i;

"Irertify, 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."
Sign
Date
Mail Annual DMR Summary Reports to:
DWO Realonal Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........(919)
807-6300
S
ASIIEVII 1.1! BF(:IONAI: OFI I(N KAYNTIT VII L,L� EC.10 AT OF„FI41 }i7QORI+SVIL1.1! RNGIQNALt)F1rICIS
2090 US Highway 70
225 Green Street !
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
j Systel Building Suite 714
Mooresville, NC 28115
[phone]
1Fayetteville, NC 28301-5043
[phone]
i [phone]
—
RALEI(,11iLIiG10NA1 OF!?lG13
A - d -- �—
WA4A11VGT(�NtRli(InNAI,QNFICN
1VILMINGTONItNG1ONAl OFFICE
3800 Barrett Drive
943 Washington Square Mall
127 Cardinal Drive Extension
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
(919) 7914200
[phone]
[phone]
WINS1'ON bAl 1?M RIr(,1ONAl
GF RAI 'O1`FLC h - --
QFFI,( N;
,
1617 Mail Service Center
------ -- ---- .
"7o
585 Waughtown Street
Raleigh, NC 27699-1617
g
' presen•e. PT*.'!
I�x
NC 27107
[phone]
ano enbanre
Nunn ca:otma's
[phone]
S W U-250NO G 19-092309

NON-STORN7WATER DISCHARGE ASSESSMENT
FORUM 7
CYPRESS COVE MARINA 175M RD. COLUMBIA, NC 2792i
DATE: 1•0 2- /
Date of
Test or
Evaluation
Outfall Directly
Observed During
the Test (identify as
indicated on the site
ma
Method Used to
Test or Evaluate
Discharge
Describe Results from
Test for the Presence
of Non-Stormwater
Discharge
Identify Potential
Significant Sources
Name of Person Who
conducted the Test or
Evaluation
j�t„ la IS
SO P — oe3
t/i-J 4 .o-
Ald
6-h b4ddf
lii

STORMWATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG190000
DISCHARGE MONITORING REPORT (DMR)
SAMPLES COLLECTED DURING CALENDAR YEAR: -;7B / S
CERTIFICATE OF COVERAGE NO. NCG7900©® (This monitoring report is due at the Division no later than 30 days from
the date the facility receives the sailing results from the laboratory.)
FACILITYNAME �t.o2eSS Cav< /)j Q1Afq- COUNTY >� /'j]yfeA_ �Ct.
PERSON COLLECTING SAMPLES. i h PHONE NO. (796 — /r j81
CERTIFIED LABORATORY�/V✓,2. a irlt { ! r Lab #
_Lab #
Part A: Specific Monitoring Renniremeruc
Ontfall
No.
Benchmark.
Date
Sample Collected
-�".tildd/`inches
,$:-_ //S
Total Rainfall
'00530
00400,-
0055fi _
-..01119
01104
01094
01114
,Total Suspended
-.; Sohds.---ih
_ „100. _-.,.;Withtn6:0=.9.0._,.:.-30
-. - pH,.
Standarduriits.
Oil &Grease,,
`- ,..._am
.::J.0007
5.O
Copper- ;
cF3L
.Aluminum'
...0.75-:<.
SS S
Zinc,-,-.
0.067.
ZS�
.-Lead ',
m
<:0.03
C.o
If a value is in
excess of the benchmark
or outside the
bench k
Z mar range (o
"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 f fines and' m ri nt for knowing violations."
(Signature of Permi ee) is
(Date)
SWU-253-092309
Page I of I

Cypress Cove Marina
Analytical and Qualitative Monitoring Requirements for
Stormwater General Permit # NCG19000
Certificate of Coverage # NCG 190094
Date of Event
Re ded Rainfall
TE-06
�ONas
Event Duration
/0 V-s
C
Sample Type
Sample Location
SD o
11I-1 Test TE-02, 05
Temperature: 9, q c
PH reading:
f Sampled By
Footnotes:
I . Measurement Frequency: Twice per year during a representative storm
event. (Oct I" thru March 31"and April t" thru Sept. 30")
2. Representative storm event: Storm measures greater than 0.1 inches of
rainfall that is preceded by at least 72 hours in which no storm outfall has
occurred. A,
;. Monitoring Location: Monitoring shall be conducted at the same
storm water discharge outfall (SDO) each time.
4. Sample Type: A grab sample will be collected with -in 30 minutes of the
event.
5. Perform testing of PH within 20 minutes.
6. Complete Chain of Custody Record Form 203 rev.04/00, copy and
overnight samples to Lab for testing. A
7. Complete Qualitative Monitoring Report Dorm SWU-242-1 12605.
S. Upon receipt of Lab certi0cate ol'analysis, complete form SWU-253-
092309 and mail original and a copy to Raleigh office within 30 days.
r,
NoteS:_�w/-., rkiijI2K.e.� -�o ZroLiiCOAIHG J e 6
.A-2

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For gui&mce on filling out this form, please visit: http:/Al2o.enr.state.ng.us/su/Foriiis Documents htmkmiscforms
Perinit No.: N/C/CK /_/_/_/_/_/ or Certificate of Coverage No.: NLIG/L/_J lQ O/ 9/1/
Facility Name: 2cs5 Co vL /G 'z�,✓,y .
County: 4 e// Phone No. ;'2-5-0 `711v
Inspector: AS, 5 _L#-IVe
Date of Inspection: / 2m / 7
Time of Inspection: .S'.'./J A-M
Total Event Precipitation (inches):
Was this a Representative Storm Event? (See information below) Yes ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
A "Representative Storm Event' is a storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no 'storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signature, I cer� fy that this report is accurate and complete to the best of my knowledge:
of Pdrmittee or Designee)
1. Outf Description:
Outfall No. %rl'"4 -3 Structure (pipe,
Receiving Stream: Sr -LA �lpC2da�a
Describe the Indus ,at activities thatoc
15ort-r -spa%re., curh2"Ye
etc.) /D-r fiLp
the outfall drainage area;
"7—P-41L0 / A/.
2. Color: Describe the color of the di charge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: 'e) A/ t .
3. Odor: Describe any ,di/stinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): _ f I A16
Page I of 2
SWU-242-112608
I

r
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy: %
t t/ 2 3 4 5
5.. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no
solids and 5 is the surface covered with floating solids:
2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
2 3 4 5,
7. Is there any foam in the stormwater discharge? .
Yes
8. is there an oil sheen in the stormwater discharge?
Yes ,! No
9. Is there evidence of erosion or deposition at the outfall?
Yes No
10. Other Obvious Indicators of Stormwater Pollution:
•' List and describe
a
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWTJ-242-112608

A
STORMWATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG190000
DISCHARGE MONITORING REPORT (DMR)
SAMPLES COLLECTED DURING CALENDAR YEAR:
CERTIFICATE OF COVERAGE NO:,NCG19©®©V (This monitoring report is due at the Division no later than 30 dayl from
/y the date the facility receives the sampling results from the laboratory.)
FACILITY NAME (: E'S ✓+' '� G/.t/� COUNTY Q/L, /
PERSONCOLLECTIN SAMPLES o .dam PHONENO.(L — 3B CEIVED
CERTIFIED LABORATORY 6Vl/,OOAJAl/ tMC. Lab # /D
Lab# OCT 24 YU=a
Part A: Snecific Monitoring Requirements
CENTRAL FILES
vf. SECTION
Outfall
No.
Date
Sample Collected,
mo/dd/Vr
Total Rainfall,
inches
00530
00400
00556
01119
01104
01094
01114
Total Suspended
Solids, m /L
pH,
Standard units
Oil & Grease,
m /L
Copper"',
m /L
Aluminum
, m /L
Zinc"'
m /L
Lead"' ,
m /L
Benchmark
100
Within 6.0 — 9.0
30
0.007
0.75
0.067
0.03
C.
!
C
•GG
G,00Sr'
' If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the 'Fier I or "I ier 2 responses in the General Permit.
' Total recoverable.
3 These benchmarks are water hardness dependant. Values shown based on a hardness of 50 mfl/L.
Solvent Management Plan Certification:
Mail original and one copy to: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit requirement
Division of Water Quality for managing solvents. I certify that to the best of my knowledge and belief, no leak, spill, or dumping of concentrated
Arm- Central Files solvents into the stormwater or onto areas which are exposed to rainfall or stonmwater runoff has occurred since filing the
1617 Mail Service Center last discharge monitoring report. 1 further certify that this facility is implementing all the provisions of the Solvent
Raleigh. North Carolina 27699-1617 Management Plan included in the Stormwate ollutio tion Plan."
L Z%
(Signa ore o Permittee) �
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"1 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 ' tprisonment for knowing violations."
/D z/ /
(Signatur of Permittee) (Da c)
Permit Date: 10/1/2009-9/30/2014 SWU-253-092309
Page I of I®

STORMWATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG190000
DISCHARGE MONITORING REPORT (DMR)
• SAMPLES COLLECTED DURING CALENDAR YEAR:
CERTIFICATE OF COVERAGE NO. NCG19©F91©® (This monitoring report is due at the Division no later than 30 day from
/y �+ the dale the facility receives the sampling results from the laboratory.)
FACILITY NAME C: 25 (.Ova {/Amu COUNTY %� k r �
PERSON COLLECTING SAMPLES o ,file PHONE NO. (ZS1-) 79 — Io 38
CERTIFIED LABORATORY�+(U.86+dA1/�tt r&e— Lab# le)
Part A: Specific Monitoring Requirements
Outfall
Date
'Sample _Collected. .:Total
.mo/dd/Vr— �.
Rainfall,
inches
00530
00400
00556
01,119.
_ O1404,
01094
01114
Total Suspended'
Solids-mg/L.
pH,
.Standard units-
Oil & Grease,
m /L
23No.
Copper"
mg/L
Aluminum"
,.m /L, . _
'Zinc"' ,
m /L
'Lead" ,
m /L
Benchmark
t00
Within:6:0 ; 9A;.
30
0.007
0 75,-
'0.067
0.03
U-
t
•a
C o
F
C,cob
' If a value is in excess of the benchmark, or outside the benchmark range (for pl-I), you must implement the Tier I or 'Fier 2 responses in the General Permit.
`Total recoverable.
3 These benchmarks are water hardness dependant. Values shown based on a hardness of 50 mg/L.
Solvent Management Plan Certification:
Mail original and one copy to: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit requirement
Division of Water Quality for managing solvents, I certify that to the best of my knowledge and belief, no leak, spill, or dumping of concentrated
Attn: Central Files solvents into the stornnvater or onto areas which are exposed to rainfall or stonmvater runoff has occurred since filing the
1617 Mail Service Center last discharge monitoring report. I further certify that this facility is implementing all the provisions of the Solvent
Raleigh. North Carolina 27699-1617 Management Plan included in the Stormwate ollutio lion Plan."
l�
_ J Z%
(Signa ure oT Perntittee) (Dal )
YOU iNIUST 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 andjfnprisonntent for knowing violations."
(Signattirt of
ld�l
(Da fe)
Permit Date: 10/1/2009-9/30/20
S W U-253-092309
Page I of

' "C CRONOS Database: Northeastern Regional Airport (KEDE) Hourly data retrieval Page 1 of 5
Station nC E - Northeastern Regional Airport Date of first observation
.
December 13, 2000
' L Station type: AWOS - III P
rpjc
City, State: Edenton, NC County: Chowan County
Latitude: 36.0285947' Longitude:-76.5697708°
I'
Elevation: 20 feet above sea level
Q
Climate division: NC08 - Northern Coastal Plain
River basin: Albemarle
Supported by: FAA / Local Aviation
L�
This page is created dynarnically and should not be bookmarked. Instead, bookmark the fge preceeding this, _
— Retrieving hourly d_a_ta, from Northeastern Regional Airport foir St.7_day(s)___
181 observations for this period of record (98.4% data available, 3 missing records)
y
If you need more historical data from a larger period of record, please contact its for assistance
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5,'114OAKMONT=;DRIVE•:;•
N.0 27835 7085: e
CYPRESS COVE MARINA
ATTN: BOBBY LANE
140 MIDWAY DRIVE
EDENTON ,NC 27932
PARAME'I'LRS
Total Suspended Residue, mg/I
Oil & Grease (HLD1), mg/I
Aluminum, ug/I
Copper, ug/I
Lead, ug/l
zinc, ug/I
slornm'aler
Analysis
Method
(NI, Grab)
Date
Analyst
Code
19
03/23/15
SDB
25401)-97
<5.0
03/21/15
SEJ
166415
555
03/27/15
LRJ
LPA200.7
432
03/27/15
LRI
EPA200.7
<5.0
03/30/15
NlTiA•1
3113R-04
254
03/30/15
JNIN'
311111-99
I
ID#: 880
hi
�e
yy�
DATE COLLECTED: 03/20/15 D
DATE REPORTED 04/09/15
REVIEWED BY: }'
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Environment I, tnc CHAIN OF CUSTODY RECORD
of
Greenville. NC 2785£ —_ g
environment l inc.com
DISINFECTION
r
Phone [phone] • Fax [phone]
CHLORINE NEUTRALIZED AT COLLECTION
CHLORINE
L
r)
pH CHECK (LAB)
CLIENT: 880 Week: 44
v
p
G
P
P
CONTAINERTYPE,PlG
:YPRESS COVE MARINA
,'17N: �,66y C.o,I,oa
None
A
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A
A
!
CHEMICAL PRESERVATION
40 MIDWAY DRIVE
:DEN7'ON NC 27932 -
A -NONE D -NAOH
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,
252) 452-7423
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w z
w
B-HNO, E-HCL
�'
I
i C-nzSv, F - ZINC ACEiAIEiiVP.JHI
COLLECTION
c
w
r.
y
GNATHIOI
SULFATE
a g'it
0
-
SAMPLE LOCATION
DATE
TIME
Stormwater (,Yl, Grab) i
ys
/
3
--
..
_
.__
j
CLASSIFICATION: J
I WASTEWATERjNPDES) 1
I
DRINKINGWATER
i
�
DWO/GW
SOLID WASTE SECTION
J
i
)
1
CHAIN OF CUSTODY MAINTAINED
i
DURING SHIPMENT/DELIVERY
Y N
SAMPLES COLECTED BY:
(Please Print)
i
j
SAMPLES RECEIVED IN LAB AT 'C
PELNQUISHED R • (SIG.) (SAMPLER)
�•
�
D�`TE/IIME
4ww
RECEKI BY (SIG.)
J
3 DATGTIME
COMMENTS:
j
DATEI M
DATERIPAE
DATETIME
RELIPlQUIS'.�D BY(SIG)
RECEIVEI B8Y__
RELINO(ASHED BY (SIG.)
DATErIME
RECEIVED BY (SIG.)
DATETIME
i
I
I
r (
PLEASE READ Instn;ctions for �romple ing t� pis `orm on the reverse .side. ul Sampler must place a "C" for composite sample or a `G" for 0
N. 286583
FORM a5 �` �' Gi ah San,pie ill the 6:ocks 3bovc i0r 2aCil paiameier rque9ted.