HomeMy WebLinkAboutNCG080841_MONITORING INFO_20190705STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑ HISTORICAL FILE
I� MONITORING REPORTS
DOC DATE
�Iyo�DS
❑
YYYYM M D D
CERTIFICATE OF
FACILITY NAME
COUNTY i',
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No NCG080000
L
Date submitted 7 L / 2
PERSON COLLIE TING SAMPLES 5o H N w Le62a T FI
LABORATORY lS 69,40 P- Lab Cert. # Lf O 2
Comments on samplecollection or analysis:
Part A: Vehicle Maintenance Areas Monitoring Requirements
SAMPLE COLLECTION YEAR ;?� 0 / 9
5 AA'TcaSAMPLE PERIOD [91'an-June ❑ July -Dec
or ❑ Monthly' month
DISCHARGING TO CLASS ❑ORW Q QW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply []SA
❑Other
R F!'"f1=I111-tom:
PLEASE REMEMBER TO SIGN ON THE REVERSE -7>
JUL &I-zoliq
CEN I fViL hf✓_E.S
DUB SE
[91No discharge this period'
Na D/s� fat
Outfall
v- i 'Date '
' k
�� 00530 ?e
gr'A,, 00400 * y
CTJON
} k ter* `r`
c F F2��
a .•
mplexCollected,
k "Total Sus ended•" a7
zx
ryy' h ,
00556 �
wi y
;, k kf
- P ;`E
4
Non Polar Oil and Grease/TPHOA �
f �Nj otor Oil Usage,.
.rid j
_
mo/dd/yr t
n5olids, mg/L w! f,
.,Standard'•umts
Methoda1664,(SGT HEM) _`Annual:averegeigel%mo
`
Benchmark
t f _
SO o�.100 see permit
k;;
=.9
mg/L
4
-
;111lithm,6.0 0
- -at....
x _ x. ,;i` . .r•:•
it ;i - <,�
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
cw. r
'� v i&' n."-nr 00530 •-`� S '
'. ' ' C
No
ample Gollected,4
r Non Polar 011 arid EPXMethod ,
w r $Total,Suspend6&S6IIds;� � ?
r :00400 .
�, � x'pH f
by
mo/d8/YrFr�
(SGGrease/TPH
rx f"} 1664THEM);'mg%L rvrar �i
�^
r m L`a C „ry
g/
x4 f
`�Stantlardauts`-
PermitiLimit .`
j r.=< �. .:_
t .. a ;- r :� f 3a -
i5.r.. a r..
F = k 5
fi .r50
m
.r. ..
, .-n
. orx100see.Pefmff.
_970
a
l5 C h1A6—C,
t For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
so 2
S W U-250
last revised October 25, 2012
Page I of 2
STORM EVENT CHARACTERISTICS:
Date 6-10 - / 9'(first event sampled) 7 i
Total Event Precipitation (inches): 6
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 1, 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 OUTFAUCTRIGGER 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 W]
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, within3O 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 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."
of Permittee)
(Date)
Additional copies of this form may be downloaded.at: http://Portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 .
S WU-250
last revised October 25, 2012
Page 2 of 2
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted 7-( - (Ii
CERTIFICATE OF COVERAGE NO1PCG08 6 J
FACILITYNAME (d66 /kc /P�Li,iff (� {{A1JUA�ocls
COUNTY "a A, /��1 e
PERSON COLLE TING SAMPLES SO H IJ w L82o7q rF1
LABORATORY /S zh60t I Lab Cent. # LSO 2
Comments on sample collection or analysis:
Part A: Vehicle Maintenance Areas Monitoring Requirements
SAMPLE COLLECTION YEAR ;Z O / 9
Sir-rywSAMPLEPERIOD [-lan-June ❑July -Dec
or ❑ Monthlyl (month)
DISCHARGING TO CLASS ❑ORW D14-QW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
❑Other__
PLEASE REMEMBER TO SIGN ON THE REVERSE -7)
RNo discharge this period'
)c 2
- —' •-- • Mdnnenance 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 Tnrmin.le
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
S W U-250
last revised October 25, 2012
STORM EVENT CHARACTERISTICS:
Date 6-10-/9(firstevent sampled)
Total Event Precipitation (inches): 4 6
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 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 ATTHE SAME OUTFALUTRIGGER 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 El
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:
"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 aware that
there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-250 last revised October 25, 2012
Page 2 of 2