NCG080161_MONITORING INFO_20190920

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

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted,
CERTIFICATE OF COVERAGE NO. NCG08 0 1 Lot
FACILITY NAME � .:ve < mac_ _ v S�•j S nc_ -
COUNTY
PERSON COLLECTING SAMPLES Pe-C `—
LABORATORY "'S6 S Lab Cert. q (4
Comments on sample collection or analysis:
ojo- ke C _\ t nned� i Cf & cNe,e
SAMPLECOLLECTIONYEAR Ze-)kq
SAMPLE PERIOD ❑ Jan -June M July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
RECEIVE® ❑Zero-flow/� ❑Water Supply ❑SA
Mother (',"o � zr
SEP 2 0 2019
r PLEASE REMEMBER TO SIGN ON THE REVERSE i
DWRCEN'GG2Al TILES
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of'h�w rr%kr oil per month? _ yes Xo
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
❑ No discharge this period'
Outfall .'
No
Date:.
Sample Collected;
s . -.
mo/dd/yr,
00530' . ''.':,
?60400
00556:
Total Suspended
,"; Solids, mg/L - " .
pH
Standard units: '.
Non -Polar Oil Grease/TPH EPA
Method 1664 (SGT_HEM); mg/L
New. Motor Oil Usage,
Anrival average gal/mo
Benchmark
'- '. -.
50"or1003eepermit
.0
Part
Outfall -
No.
-Date ,.
Sample Collected,
mo/dd/yr
00556
00530
00400
Non=Polar Oil and Grease/TPH EPA Method ,
1664 (SGT-HEM); mg/L
' Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit '
,: 15
50 or 100 see permit
6.0 — 9.0
k
12.E
59 nnia I L_
—A.2$
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last reviscd April 11, 2013
Paac I of 2

y..

STORM EVENT CHARACTERISTICS:
Date�kt i 3I t S (first event sampled) IN
Total Event Precipitation(inches): O._qQ
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
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 ANY ONEOUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES Q NO
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR includino all "No Discharge" reports within 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 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 subm!tted 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."
! 1 B,Li 1—
(Date)
Additional copies of this form may be downloaded at! htto:./nor[aLncdenr.or,/web/wc /ws su �n 1j desswttteb-4
S W G-2 i 0 last rcviscd April 11, 201
Paec 2 of 2