NCG120087_MONITORING INFO_20191107

T:17/(3
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/Y
DOC TYPE
❑ HISTORICAL FILE
[MONITORING REPORTS
DOC DATE
❑
YYYYMM DD

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑ HISTORICAL FILE
f MONITORING REPORTS
DOC DATE
❑ ��� ° a
YYYYMMDD

DocuSign Envelope ID: A107EA01-968A-4EFA-AFBE-85058547184E
SMITH+GARONER
111610Ef05
October 31, 2019
North Carolina Department of Environmental Quality
Division of Water Quality
Attention: DWO Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Discharge Monitoring Report - August 2019
Johnston County Landfill (Permit No. 51-03)
Certificate of Coverage #NCG120087
General Permit #NCG120000
Dear Sir/Madam:
ADDRESS TEL WEB
14 N. Boylan Avenue, Raleigh NC 27603 919 B28 0577 www.smithgardnefinc.com
RECEIVED
NOV 0 7 20to
C..t;ty
DW R SFCT%pNS
go
Smith Gardner, Inc. (S+G1 is pleased to submit this Discharge Monitoring Report (DMRI for the Johnston County
Landfill. The site is located in Smithfield, North Carolina. The facility is currently permitted to discharge water
from landfill related activities under Certificate of Coverage (CDC) Number NCG120087, General Permit Number
NCG 120000.
Request for Representative Outfall Status' was granted to Johnston County Landfill by the North Carolina
Department of Environmental Quality (NCDEQ), Division of Energy, Mineral and Land Resources (DEMLRI.
Currently, the facility is required to monitor discharge at the fotlowing Stormwater Discharge Outfall (SDO1
locations:
11 SDO4A-5A,
21 SDO A;
3) SOO B.
The site is in Tier 3 status at SDO 4A-5A (February 2, 20151 for Total Suspended Solids (TSSI and fecal coliform;
however, there were no qualifying rain events realized at SDO- 4A-5A during the month of August.
For this submittal, we are providing you with two (21 copies of the DMR report.
If you have any questions, or require further information, please contact us at (9191 828-0577 or by e-mail.
Sincerely,
SMITH GARDNER, INC.
EDoc nSig SE88eE429GG.a by:
C �
Mary C. Kennamer, E. I.
Staff Engineer, ext. 146
marvfasmithgardnerinc.com
CC: Rick Proctor (Johnston County)
Pieter Scheer, P.E. (S+GI
File
Attachment
DocuSigned by:
B9))9 9BA111 F48 .
Joan A. myth,P.G.
Senior Hydrologist, ext. 221
ioanfdsmithoardnerinc.com
HAProjects\lohnston County MAN JC Compliance\03 JC NPDES\Monitonng Reports\201 %08- August\DEMLRnpdes Penod 2019 08 docx
' Smith Gardner, Inc. letter to Division of Energy, Mineral and Land Resources. Resubmitta( - Representative Outlat(Status
Petition /NCG #1200871.. August 14, 2014.

DocuSign Envelope ID: A107EA01-968A-4EFA-AFBE-85058547184E
This page intentionally left blank.

DowSign Envelope ID: A107EA01-968A-4EFA-AFBE-850585471B4E
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG120000
Date submitted October 31, 2019
CERTIFICATE OF COVERAGE No. NCG12 0 0 8 7 SAMPLE COLLECTION YEAR 2019
FACILITY NAME Johnston County Landfill SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
COUNTY Johnston aC^Cor ❑■ Monthly' August fmonth
ECEI"l
PERSON COLLECTING SAMPLES Seth Rlckerts (S-G, Inc.) r V EQ DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY ENCO Laboratory AabCert. # 591 Nfl� 0 2�I9 ❑Zero-flow❑Water Supply ❑SA
Comments on sample collection or analysis: QOther s
CEN-I NAL FILES
SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results
i
❑■ No discharge this period'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Chemical Oxygen
Demand
mg/L
Fecal r,.o r 100
Colonies per 300 ml
Total Suspended
Solids
mg/L
pH'
Standard Units
Benchmarks
-
-
120
10DO
100 or 50'
6.0-9.0
Parameter Code
-
46529
W340
31616
cosso
00400
SOO 4A-5A
8/31/2019
No discharge this period.
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
'For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format. "<XX mR/L". where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
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.
Permit Date: 11/l/2018-5/31/2021 SWU-248, last revised 11/1/2018
Page 1 of 2

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DocuSign Envelope ID: A107EA01-968A-4EFA-AFBE-850585471B4E
Semi-annual Stormwater Discharge Monitoring Resort
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG120000
Date submitted ootober 31, 2019
CERTIFICATE OF COVERAGE No. NCG12 0 0 8 7
FACILITY NAME Johnston County Landfill
COUNTY Johnston
PERSON COLLECTING SAMPLES Seth Rlckerts (S-G, Inc.)
LABORATORY ENCO Laboratory Lab Cert. # 591
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2019
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or ❑■ Monthly' August (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
QOtherC.NSW
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
❑■ ((Vo discharge this period'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Chemical Oxygen
Demand
mg/L
Fecal per Col100
Colonies per 100 mL
Total Suspended
Solids
mg/L
Standard Units
and
Benchmarks
_ -
-
120
1000
100 or 504
6.0-9.0
Parameter Code
-
46529
00340
31616
Co53o
00400
SOO 4A-5A
8131/2019
No discharge this period.
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
' See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported In numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format. "<XX mg/L", where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
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.
Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018
Page 1 of 2

DocuSign Envelope ID: A107EA01-968A-4EFA-AFBE-850585471B4E
Part B. Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
i n No discharae this Deriadz
Outfall No.
Date Sample Collected'
(mo/dd/yr)
24-hour rainfall amount,
Inches'
Non -Polar Oil & Grease
mg/L
Total Suspended Solids,
mg/L
New Motor or Hydraulic Oil Usage,
gal/mon
Benchmarks
_
-
15
100 or 504
Parameter Code
-
46529
00552
C0530
NCOIL
Footnotes from Part A also apply to this Part B
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 ONE OUTFALL? YES 0 NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES Q NO ❑
REGIONALOFFICE CONTACT NAME:
Mail an original copy of this DMR including all "No Discharae" 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: D W Q 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
Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018
Page 2 of 2

DocuSign Envelope ID: BBBCCC28-7CB8-4D8E-985C-E8058600AB70
Semi-annual Stormwater Discharge Monitoring Report [Zd"
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG120000
Date submitted 6121 19
CERTIFICATE OF COVERAGE NO. NCG12 0 0 8 7
FACILITY NAME Johnston County Landfill
COUNTY Johnston
PERSON COLLECTING SAMPLES Rick Proctor ���;
LABORATORY NA Lab Cert. # C
Comments on sample collection or analysis: JUL Z zOl9
No Flow This Month
GEfIR S/�Cl IOPd
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2019
SAMPLE PERIOD ❑ Jan -June ❑ Juty
or 0 Monthly' M; Y-44ec
/month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
[]Zero -flow ❑Water Supply ❑SA
Mother C;NSW
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
n No discharae this oeriod2
Outfall No.
Date Sample
Collected'
(ma/dd/yr)
24-hour rainfall
amount,
Inches'
Chemical Oxygen
Demand
mg/L
Fecal Coliform
Colonies per 100 ml.
Total Suspended
Solids
mg/L
pH'
Standard Units
Benchmarks
_
-
120
1000
100 or 504
6.0-9.0
Parameter Code
-
46529
00340
31616
C0530
00400
SDO 4A-5A
NA
NA
No Flow
No Flow
No Flow
No Flow
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
1 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
' See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
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.
Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2o18
Page 1 of 2

DocuSign Envelope ID: 88BCCC28-7CB8-4D8E-985C-E8058600AB70
Part 13: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > SS gal of new oil per month.
m
Outfall No.
Benchmarks
Date Semple Collected'
(mo/dd/yr)
_
24-hour rainfall amount,
Inchesa
-
Non -Polar Oil & Grease
mg/L
15
No u1schar
Total Suspended Solids,
mg/L
100 or 504
a this penoa-
New Motor or Hydraulic Oil Usage,
gal/mon
_
Parameter Code
-
46529
00552
CO530
NCOIL
SDO 4A-5A
NA
NA
No Flow
No Flow
NA
mtnntpe frnm Dae•
a ale.. a . i. •.. Hu:- n_.r
n
�.........�...... oyy,r w vua rma v
Note: If you report a somple 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 ATTHE 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 Q NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES 0 NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an orlalnal copy -of this DAM including all "No Discharge" reports within 30 days of receipt of the lab results for at end of monitoring Period in the
case o/ No Dischame" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mall 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."
Signature of
Permit Date: 11/l/2018-5/31/2021
G/is
Date
s .
SWU-248, last revised 11/1/20ig�`
Page 2 of 2

DocuSign Envelope ID: D8F125A4-2148427E-B671-lCD491E62AlF
SMITH+-GARUNER
E l.* i:,10
August 5, 2019
—_ L0.1
14N. EsyIdn Avegwe.@21e:gh NC27EG3 vuu?a OS/t :rnesnrhga:an!ci. .�
North Carolina Department of Environmental Duality
I(r
RECEIVED
Division of Water Duality
Attention: DWO Central Files
SEP Q 5 2��9
1617 Mail Service Center
Raleigh, NC 27699-1617 •
CENTRAL FILES
RE: Discharge Monitoring Report — July 2019
DWR SECTION
Johnston County Landfill [Permit No. 51-03)
Certificate of Coverage ONCO120087
General Permit #NCG120000
Dear Sir/Madam:
Smith Gardner, Inc. IS.G) is pleased to submit this Discharge Monitoring Report (DMRI for the Johnston County
Landfill. The site is located in Smithfield, North Carolina. The facility is currently permitted to discharge water
from landfill related activities under Certificate of Coverage (CDC] Number NCG120087, General Permit Number
NCG120000.
Request for Representative Outfatl Status' was granted to Johnston County Landfitl by the North Carolina
Department of Environmental Quality INCDEQI, Division of Energy. Mineral and Land Resources (DEMLRI.
Currently, the facility is required to monitor discharge at the following Stormwater Discharge Outfatl (SD0)
locations:
11 SDO 4A-5A,
21 SOO A;
31 SDO B.
The site is in Tier 3 status at SDO 4A-5A (February 2, 20151 for Total Suspended Solids (TSSI and fecal coliform;
however, there were no qualifying rain events realized at SDO- 4A-5A during the month of July.
For this submittal, we are providing you with two (21 copies of the DMR report.
If you have any questions, or require further information, please contact us at 19191 828-0577 or by e—
mail -Sincerely,
SMITH GARDNER, INC.
Mary C. Kennamer, E. L
Staff Engineer, ext. 146
marvrdsmithoa rd neri nc.com
CC: Rick Proctor (Johnston County)
Pieter Scheer, P.E. (S.GI
File
Attachment
o aan.a ey:
jmo- �A..l1FSwf�
il?W JfLly W.T.G.
Senior Hydrologist, ext. 221
i oa nfasmith ca rd ne ri n c.co m
H:Nro^tsUo�nsion County INCFA2 JC CompuancA09!C NPUES\Monnanng Heppro M 9t07- Ju y\UEIALeppdf Period 2019_07.doa
' Smith Gardner, Inc. letter to Division of Energy. Mineral and Land Resources. Resubmittat - Representatim Outtatt Status
Petition /NCG #1200917 August 14. 2014.

DocuSign Envelope ID: D8Fl25A4-2148-427E-B671-1CD491E62A1F
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG120000
_.. _. Date submitted August 5,2019
CERTIFICATE OF COVERAGE No. NCG12 0 0 8 7
FACILITY NAME Johnston County Landfill
COUNTY Johnston
PERSON COLLECTING SAMPLES Seth Rickerts (S-G, Inc.)
LABORATORY ENCo Laboratory
_ Lab Cert. # 5e1
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2019
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or ❑■ Monthly' Ju1Y (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑2ero-flow ❑Water Supply ❑SA
❑E OtherC.NSw
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
11=7 IV_ J:__L_.-_ a, -
Outfall No.
of
Date Simple
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Chemical Oxygen
Demand
mg/L
Fecal Coliform
Colonies per 100 mL
.vim unumrye rms perrou-
Total Suspended
smg/L
PH,
Standard Units
8enchmarla
_
-
120
1000
100 or 504
6.0-9.0
Parameter Code
-
46529
00340
31616
C0530
00400
SDO 4A-5A
7/31/2019
No discharge this period.
Monthly sam lin (instead
I
p g semi-annua ) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
' For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported In numerical format. For example. do not report Below Detection. Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format "<XX me/L" where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
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.
Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2o18
Page 1 of 2

DocuSign Envelope ID: 08F725A4-2148-427E-B671-1CD491E62AIF
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
No disc har a this periodz
Outfall No.
Date Sample Collected'
(mo/dd/yr)
24-hour rainfall amount,
Inches$
Non -Polar Oil a Grease
mg/L
Toted Suspended Solids,
mg/L
New Motor or Hydraulic Oil Usage,
gal/mon
Benchmarks
_
-
1s
100 or 5W
Parameter Code
-
46529
00552
00530
NCDIL
Footnotes from Part A also apply to this Part B
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 ANYONE OUTFALL? YES Q NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ONO[]
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR indudina all "No Discharge" reports within 30 days of receipt of the lab results for at end of monitorina 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
Permit Date: 11/l/2018-5/31/2021 SWU-248, last revised 11/1/2018
Page 2 of 2

DocuSign Envelope ID: 645C3734-24F0-4234-891B-A813CF10601B
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG120000
Date submitted 07/10/19
CERTIFICATE OF COVERAGE NO. NCG12 0 0 S 7
FACILITY NAME Johnston County Landfill
COUNTY Johnston RECEIVED
PERSON COLLECTING SAMPLES Rick Proctor
LABORATORYNA Lab Cert. g NA 7dlg
Comments on sample collection or analysis: GENT RAL FILES
No Flow This Month MAIR SECTION
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2019
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or ®❑ Monthly' Tun G (month)
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
❑Zero -flow []Watersupply ❑SA
QOtherC;NSW
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
K No discharge this period2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Chemical Oxygen
Demand
mg/L
Fecal per 100
Colonies per 300 mL
Total Suspended
Solids
mg/L
and
Standard Units
Benchmarks
-
-
120
1000
100 or SW
6.0-9.0
Parameter Code
-
46529
00340
31616
COS30
00400
SOO 4A-5A
NA
NA
No Flow
No Flow
No Flow
No Flow
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outran.
' For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BOIL, <PQL, Non -detect, NO, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
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.
Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018
Page 1 of 2

DocuSign Envelope ID: 645C3734-24F0-4234-891B-A813CF10601B
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
n Nn rficrhnrnn this norfnrR
Outfall No.
Date Sample Collected'
(mo/dd/yr)
24-hour rainfall amount,
Inches'
Non -Polar Oil & Grease
mg/L
Total Suspended Solids,
mg/L
New Motor or Hydraulic Oil Usage,
gal/mon
Benchmarks
_
-
15
100 or 5W
Parameter Code
-
46529
00552
C0530
NCOIL
SDO 4A-5A
NA
NA
No Flow
No Flow
NA
Footnotes from Part A also apply to this Part IS
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 EXCEEOANCE 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 OUTFALL7 YES Q NO ❑
IF YES, HAVE YOU CONTACTED THE DEMUR REGIONAL OFFICE? YES E] NO
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR including 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 submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of
Permit Date: 11/1/2018-5/31/2021
Date
SWU-248, last revised 11/1/2018
Page 2 of 2