NCG030151_MONITORING INFO_20191023

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO. Iv Cc 3 b
FDOC TYPE. ❑ HISTORICAL FILE
FA MONITORING REPORTS
DOC DATE ❑ J 3 10 3
YYYYMMDD

0-0)
RECEIVED
OCT 2 3 2019
CENTRAL FILE;,
DWR aECTION
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out thisfonn, please visit: http:i/h2o.enrstate.ncus/su/Forms Dpcumenis.htniRmisciorms
Permit No.: N/C/GIO�1J3'101 I /5 J / or Certificate of Coverage No.: N/C/G/_0/3p/0p0/
Facility Name:
County: 14.,li a Phone No. a5 -S3(e-a06LIL
Inspector:
Date of Inspection: N A
Time of Inspection: NZA
p
Total Event Precipitation (inches): N A
Was this a Representative Storm Event? (See information below) ❑ Yes 0 No
Please check your pennit 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 certif at thisyPort is accurate and complete to the best of my knowledge:
n
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): .
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S WU-2a2-112608

4. Clarity: Choose the number which best describes the clarity of the discharge, where l is clear
and 5 is very cloudy:
l 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:
1 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I is no solids and 5 is extremely muddy:
1 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
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
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.
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SWU-242-112608

Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG030000
Date submitted 1 Q- g- 1 9
CERTIFICATE OF COVE/RRAGE NO. NC 03 OQ Q Q
FACILITY NAME /`_C Rme
COUNTY r
PERSON COLLECTING SAMPLES
LABORATORY
Lab Cert. 4
ments on samplg collecajon pr analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or ❑ Monthly' /rnonih)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
[]zero -flow ❑Water Supply ❑SA
[_]Other
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 -)
Vf No dischorae this period?Z
Outfall No.
Benchmarks
Date Sample
Collected'
(mo/dd/yr)
-
24-hour rainfall
amount,
Inches'
-
Total Suspended Solids
P
100 mg/L or 50 mg/L'
PH,
Standardand units
6.0 - 9.0
Total Copper
0.010 mg/L
Total Lead
0.075 mg/L
Total Zinc
0.126 mg/L
Non-Polar O&G/
Total Petroleum
Hydrocarbons
15 mg/L
Total Toxic
Organics s
1 mg/L
Parameter Code
46529
C0530
00400
01119
01051
01094
00552
78141
N
I
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceecance for the same pardmetur atuie Saine C)Utla �.
=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, Section B, Table 1 to identify the especially sensitive receiving water classifications where the more protective benchmark applies.
' Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; far electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2018-05/31/2021 SWU-245, last revised 1113.12018
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Facilities that incorporate a solvent management plan into the Stormwater PollutionPrevention -Plan -may so certify, and the requirement for TTO-monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwaterrunoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the stormwater Pollution Prevention Plan."
Dc,si I r K� �,
Name (Print name)
_ (Oholl
Signature Date
Note: Results must be reported in numerical format. 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, 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.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period ?2
Outfall No.
Date Sample Collected'
(mo/dd/yr)
24-hour rainfall amount,
Inches'
New Motor Oil or
Hydraulic Oil Usage
Non -Polar O&G/ Total
Petroleum Hydrocarbons
Total Suspended
Solids
Benchmarks
-
-
-
15 mg/L
100 mg/L or 50 mg/1-4
Parameter Code
-
46529
NCOIL
00552
CO530
Footnotes from Part A also apply to 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.
Permit Date: 11/1/2018-05/31/2021 ' • SWU-245, last revised 11/1/2018
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FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FORTH E SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original coov of this DMR, includinq 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 Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-161.7
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 avtacg that theme significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Permittee
Permit Date: 11/1/2018-05/31/2021
CL/ IV
SWU-245, last revised 11/1/2018
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