NCG030412_MONITORING INFO_20191210

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE. ❑ HISTORICAL FILE
[MONITORING REPORTS
DOC DATE ❑ ��� �1.Ja J D
YYYYMMDD

Semi-annual Stormwater Discharge Monitoririg Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG03 0 -Q� 0 Q
FAGLITYNAME Mann t H Lw%mP-1 {°urnlo i a
COUNTY C& rn
PERSON COLLECTING
Cart #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR `LO
SAMPLE PERIOD ❑ Jan -June my -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
❑2ero-flow ❑Water Supply ❑SA
AFC , ��,. ❑Other
1 p
pyt R1 icz-o
� T/DES
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
n No discharqe this period?'
Ori.tf. alBNo ,.
. ' .. . ,
.
DatdSm
.czedt
.(co'o/dd%ysL
24h
. ..inches ....
TotalSuspended$bas
.. „ ;. � _ , . -> : -,
-
dd"
Coppec
Lead
Ziia
- _
NbHYSa-iP,PoeiatrorrOe&uGm/
x . •.,..
TOif
r nias
,m ot50;m6irl•-9.D
.f0,00fi:' J
i0) �:
006 g
-, .,.15im�/L+'
].mg/C .
11 I2
-7. S3 nq)L
o %00
0,0
G l• 0 L
Nb
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
' Forsampling periods with no discharge at any single'!outfall, you must still submttthis discharge monitoring'report with a checkmark here.
3The total precipitation must be recoided using data from arf on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement
See General Permit, Table 3 identifying `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; forsemiconductor
manufacture use the definition as found in 40 CFR 469.12; for 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: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
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Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention 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 fortotal 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
stormwater runoff 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 Stornwater Pollution Prevention Plan."
'73_O.SI1V.A S,�elle2
Nanie (Print name)
Title (Print title) -
t- lure) (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQI_,.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, rrer 2, or tier 3 responses. see Genera/ permit text'
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this periodi
Outfalf-Noamount fall Nbn-polar o&G/TP.Hbv��
Footnotes from Part A also apply to this Part B
*See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
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l
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Trer 2, or Tier 3 responses. See General Permit text
FOR PART A AND PART B MON ITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTEDTHE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Maifan oriainal and one coov of this DMR including all 'No Discharge" reports within 30 dovs of rereipt of the !ab results for of end of monftorina period
in the case of "No Dischame" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
. YOU MUST SIGN THIS CERTIFICATION FORANY 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."
l/—as—.?or9
(Date)
Permit Date: 11/1/2012-30/31/2017 SWU-245, last revised 10/25/2012 .
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