NCG080057_MONITORING INFO_20190701

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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
1vC� b b OS�
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ 7 I
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCGO80000
Date submitted 0p/9
CERTIFICATE OF COVERAG, NO. NCG08 '
FACILITY y8p4E / N r prY,
COUNTY
PERSON COLLECTING SAMPL S /
LABORATORY i — /Lab Cent. V/d/O
Comments on sample collection orfanalysis
00 .
SAMPLE COLLECTION YEAR 0701f
SAMPLE PERIOD CE71an-June ❑July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow []WaterSupply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? 1LJ' yes ❑ no (±Xt& complete Part A)
Part A: Vehicle & Equipment Maintenance Areas Monitoring Requirements (If applicable) ❑ No discharge this period
Outfall No.
Benchmarks
th
Date Sample Collected' 24-hour rainfall amount, Non -Polar Oil & Grease
(mo/dd/yr) Inches' mg/L
_ - 15
Total Suspended Solids,
mg/L
100 or SW
New Motor or Hydraulic Oil Usage,
gal/mon
Parameter Code
OO,
- 46529 OOSS2
Ci
C0530
NCOIL
Monthly sampling
(instead of semi-annual) must be in 'th
g wl a 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.
45ee 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, " X% a/L" where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliforPRults exceed�ttie dduti n upper limit, report the result as ">XX".
JUL 0 1 Z019
Permit Date: 11/1/2018-5/31/2021 CENI Wi L FILES SWU-248, last revised 11/1/2018
DWR SECTION Page I oft

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 50'
6.0-9.0
15
Parameter Code
46529
C0530
00400
00552
Footnotes trom Part A also apply to this Part 8
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER I REQUIREMENTS. SEE PERMIT PART I SECTION B.
• 2EXCEEDANCE5 INA 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 ATANY ONE OUTFALL? YES ❑ NO P-
IF YES, HAVE YOU CONTACTED THE DEMUR REGIONAL OFFICE? YES ❑ NO [—
REGIONAL OFFICE CONTACT NAME:
Mail an original coat/ of this Dill including off "No Discharge" reports, 'thin 30 days of receipt of the lab results for 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 27699-1617
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 direRion or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry ofthe 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
ree ttohaatt there
are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature rmittee I
Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018
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