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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ d �� la
YYYYM M D D
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted
CERTIFICATE OF COVERAGE NO. NCGO80905
FACILITY NAME Glen Raven Logistics, LLC
COUNTY Alamance
PERSON COLLECTING SAMPLES Mike Murray
LABORATORY Pace Analytical Lab Cert. p 633
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR 2019
SAMPLE PERIOD ❑ Jan -June 0 July -Dec
RCCE/t/, or Monthly' (month)
DISCHARGING [ICHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
DEC 2, 6 2019 ❑Zero -flow Water Supply ❑SA
CFNT ❑Other
°N'R S CPILES
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? X yes _no
(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
ple Collected,
F '.,',,mo/dd/yr
00530,
;,, .. 00400
"Total Suspended
Solids; mg/L
ff ��: pH,
- ` Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark"
:.'.'' ' ..
50 or160 see'per'mit
Within 6.0-9.0 '' '
"' 15
1
12/02/2019
3.6
7.3
ND
73
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (if applicable)
Outfall ';'
No ?
,.
Date
)`Sample Collected,
5.... 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 .
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
— - _ last revised April 11, 2013
S_WU_250_ - - Page 1 of
STORM EV CH RACTERISTICS:
Date: 12/2/2019 (first event sampled)
Total Event Precipitation (inches): 0.55
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 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 ANYONE 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:
"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."
/Z l!o h7
(Signature of Permi ee) (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/`wsZsu/npdessw#tab-4
SWU-250_ -- - -- — - - - - - = last revised April 11 2013-
_ - Page 2 of 2