NCG080198_MONITORING INFO_20180418

1 1 43
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCG d� V b
DOC TYPE
❑ HISTORICAL FILE
[V-MONITORING REPORTS
DOC DATE
❑ ��/ ��
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
�)C(_ C7� q> (D / , 7 —,�-CA-
-Date submitted 9tx
CERTIFICATE OF COVERAGE No. NCG08 o O O 0
FACILITYNAmi; L19K TRLIcKIrQCjiNC-
COUNTY A -A] 9 0 r-J
PERSON COLLECTING SAMPLES
LABORATORY Lab Cert. #
Comments on sample collection or analysis:
Part A: Vehicle Maintenance Areas Monitorinij Requirements
SAMPLE COLLECTION YEAR 2018
SAMPLE PERIOD [—] Jan -June E] July -Dec
or KMonthlyl An.4iud (month)
DISCHARGING TO CLASS F]ORW E]HQW []Trout [_]PNA
E]Zero-flow FlWatersupply FISA
[:]Other
APR 18 2018 PLEASE REMEMBER TO SIGN ON THE REVERSE
C L'• No discharge this period
C7-10P,
T� ".'bui
Collected,
R!,
4k A9TP P§R
I'T
1� 'T,
'A
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? yes _no
(if yes, report your analytical results in the table immediately below)
Part B: Oil/water Separators and Se . condary Containment Areas at Petroleum Bulk Stations and Terminals
?Non Polar CIII and EPA;Mkh6d
Total Suspended $ohds,
;pH;
No
Sample Collected,
b
aknits:';
rcP
50
-0�
6 O
i*or-* seerpermi
For sampling periods with no discharge,at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
swu-25r,,, IF --visedr25,2012.
Paae 1 of 2

i .
STORM EVE.: P' CHARACTERISTICS:
Date (first event sampled)
Total Event Precipitation (inches):
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 AAND PART MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
C 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
a TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES [] NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
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 r ponsibie for gather' g e information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. 1 am aware that
there ar ignifi t gei afar e for bmitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
!a / i'i
(Date)
Additional copies of this form may be downloaded at: http:llportal.ncdenL.—O—rgZweb/wcj/ws/­suZnpdessw#tab-
SWU-250
last revised October 25. 2012

Semi-annual Stormwater Discharge Monitoring Report -hp
for North Carolina Division of Water QuaJitv, General Permit No. NCG080000
gvp9 Date submitted 1,111.410
CERTIFICATE OF COVERAGE.NO. NCG08 O 0 6 . SAMPLE COLLECTION YEAR oz O ( %
FACILITY NAgE L16 K TX(AcKi/JG /NC • SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
COUNTY / (SON / or Monthly' bFC/=M/3k�e— (month)
PERSON COLLECTING SAMPLES DISCHARGING TO CLASS ❑ORW ❑HQW [:]Trout ❑PNA
LABORATORY Lab Cert. #
RF:rF11/F:D Zero -flow ❑Water Supply ❑SA Comments on sample collection or analysis: JAN 19 2Cq Other
INFORMATION PROCESSING UNIT
Part A: Vehicle Maintenance Areas Monitoring Requirements
PLEASE REMEMBER TO SIGN ON THE REVERSE a
No discharge this period'
Outfall 4,
No`
1' 'Date, ''
Sample Collected,
s , 00530'� ,`
06400
r 00556 _
i
4 zTotal Suspended `t
`<.Sohdsjmg/L'
A pH; f
;.,'r'Standardumts
Non Polar Od and Grease/TPH
r..
y., Method.1664(SGT-HEM), mg/L: ;.
New Motor Oil Usage,
-.
''Annualaverage;gal/mb
x
Benchmarkw{=-ori100
seeEpermlt,
•Wlthm 6 0 , 9.0.:,
,, :•.', ?c 15 • , ;.r
s -2
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no
(if yes, report your analytical results in the table immediately below)
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals
rJOUtfall Y�J
No
M F �
Date
Sample Collected,)
_...,.. ...> c:.. 00556 , : ,
00530� a
00400:;
Non Polar Oi and Grease/TPH+EPA Method
:1664(SGT-HEM),;mg/�z.. x
s _Total Suspended Solids,
......: ... ......mg/L1 ,> " r
pH, '
"Standaril'unrts -.,.
rmit:Cimit`
15
^' ' SO or:100 see;
6.0 :90
For sampling periods with no discharge,at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-25(/1: -wised r 25, 2012
D•f Paee 1 of 2

STORM EVE.: iCHARACTERISTICS:
Date (first event sampled)
Total Event Precipitation (inches):
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 :t 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 ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR including all "No Discharge" reports within 30 days of receipt of the lab results (or 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:
"[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 area nificant b penalties for itting fa)e information, including the possibility of fines and imprisonment for knowing violations."
/ 1--)
i iX 9
(Date
Additional copies of this form may be downloaded at: htti2://portal.ncdenr.orglweb/wq/ws/sulnpdessw#tab-4
SV✓L -250 last revised October 25, 2012
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