NCG080007_MONITORING INFO_20200122

47"
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
q(- G V U O V
DOC TYPE
❑HISTORICAL FILE
E, (MONITORING REPORTS
DOC DATE
❑ ad V o/ �a
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and L d rResources General Permit No. NCG080000
Date submitted
CERTIFICATE OF COVERAGE NO. N00080 D O
FACILITY NAME ''// /VEer _
COUNTY //.PAP AiA
PERSON COLLECTING SAMPLES
LABORATORY is vte
Comments on sample col ectioi
;S Lab Cert. »
or analysis:
SAMPLE COLLECTION YEAR
SAMPLE PERIOD ❑ Jan -June [y July -Dec
or ❑ Monthly' (month)
R��Fjkrf-HAkGINGTOCLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow [Water Supply ❑SA
JAN 2 2 2020 ❑other 7�
CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4
DWR SECTION
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? P yes ❑ no (if yes, complete Part A)
Part A: Vehicle & Equipment Maintenance Areas Monitoring Requirements (If applicable) ❑ No discharge this period'
Outfall No.
Date Sample Collected'
(mo/dd/yr)
24-hour rainfall amount,
Inches3
Non -Polar Oil & Grease
mg/L
Total Suspended Solids,
mg/L
New Motor or Hydraulic Oil Usage,
gal/mon
Benchmarks
_
-
15
100 or 504
Parameter Code
-
46529
00552
C0530
NCOIL
/do<
L
< loom
' 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 1, 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, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018
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Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) ❑ No discharge this period
Outfall
No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Sample Collected'
mo/dd/yr
Total Suspended
Solids,
mg/L
pH,
Standard units
Non -Polar Oil &
Grease,
mg/L
Permit Limit
_ -
-
-
100 or 504
6.0 — 9.0
15
Parameter Code
-
46529
-
C0530
00400
00552
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 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 II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES [:]NO[]
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original copv of this DMR, including all "No Discharae" reports, within 30 days of receipt of the lab results (or at end aLmonitorina period in the
case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
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 awa_cpthat there are signif; ant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of
Permit Date:11/1/2018-5/31/2021
2t
SWU-248, last revised 11/1/2018
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