NCG080109_MONITORING INFO_20191119

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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑ HISTORICAL FILE
E)(MONITORING REPORTS
DOC DATE
❑ �'y -I I� g
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted IrL%'zoirf
CERTIFICATE OF COVERAGE No. NCG08 0 L .0 19
FACILITY NAME C1.}A2Lc:Tt- PAC-NWRS f(JARt� TR✓GllinYl
COUNTY /11"L-"U[ L�u71✓YL(s:......
PERSON COLLECTING SAMPLES' M1cgA9-L ICir 1•Vrrt%ci,(
LABORATORY 'Sia4'ncy F_„yjaouxtlfl`eb_Cert. # E= X76S�
Comments on sample collection or analysis:
Part A: Vehicle Maintenance'Areas Monitoring Requirements"
SAMPLE COLLECTION YEAR ZOIcf
SAMPLE PERIOD ❑ Jan -June ® July -Dec
--or..-[:] Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
RECEIVED _._.- 160ther dggQK �
NOV 19 2019 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL FILES period'
DWR SECTION � .No dischdr this , gP.
Ou fall
Date
° 00530
w E00400 r
:; DOS56
Total Sus i_ndeda'
p
-s r p ',
Non Polar Oil and Grease/TP.H EPA
New Motor Oil Usage,
s No.
Sample Collected;
mo/d_d/,yr
Solids, rngJl
4H
Standard units ;.7K
Method 1664'(SGT HEN1); mg/L
Annual average gal/mo
- -
xBenchmark50;or1001seeYpe
init;;
_-
Withm,60� 9.0i c
15 `)
pa
L
Did this facility perform VehicleiMaintenance Activities using more than 55 gallons of new motor oil per month? _ yes 7t no
(if yes, rep6rVyour analytical results in the'table imiTied iatelybelow)"
PartB: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals
Y• Outfall
'? rNo - r
Date
Sample Collected,
mo% d%yr
u : 06556 r'
OQ530
00400
Non Pola�f0il and`Grea a/TPH EPA Method
N 1664 iSGy T FIEM), mg/L r?s
Total Suspended Solids,
w� t' .' i c '`m_ g/L
H
; , - p ,.
Standard units
Pe m t°Limitr:s
�:1c'tf
:.15 a ai t .'
S0 or100 see,permit _
^` `, _ 6.0,= 9.0
For sampling periods with no discharge atanysingle outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 ( last revised O .',r 25, 2012
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STORM EVENT CHARACTERISTICS:
Date- ,jc;4221IN(first event sampled)
Total Event Precipitation (inches): . ZO
-Date (list each additional event sampled this reporting period; and rainfall amount)
Total Event Precipitation (inches):
Note. If you report a sample value to excess of the benchmark; you must implement Tier1, Tier 2 or Tier g responses. See General Permit text:
FORrPART:A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER REQUIREMENTS. SEE -PERMIT PART II SECTION B. '
• 21EXCEEDANCES•IN-A ROW FOR'THESAME PARAMETER AT THE SAME OUTFALLrTRIGGER TIER 2-REQUIREMENTS. SEE PERMIT PART II1SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES [:]NOD
IF YES, HAVE-Ybu CONTACTED THE DWQ REGIONACCOFFI 5 YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center- 4,t,;,,• "` - --A
Raleigh,.North Carolina 27,699-1617
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 re'sponsikilefor gathering ttieinformation,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."
IIIIZ/14
(Signature 'oT`PermitteeJ" +' (Date)
Additional copies of this form maybe downloaded at: http://Portal.ncdenr.org/we6/wq/Ws/su/npdessw#tab-
4•_ -
;
SWU-250
last revised October'25, 2012
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