NCG120099_MONITORING INFO_20190717

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NC / D u 9 9
DOC TYPE
❑ HISTORICAL FILE
E� MONITORING REPORTS
DOC DATE
❑ �� 7 I
YYYYMMDD

WS0D
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Qu lit General Permit No. NCt/ Z 000 00
Date submitted
CERTIFICATE OF COVERAGE NO. NCG3,2_g CU 23
FACILITY NAME 4t Ili w4s (7- D Z04406W,
COUNTY _
PERSON COLLECTING SAMPLES
LABORATORY Lab Cert. P
Comments on sample collection or analysis:
Part A: Vehicle Maintenance Areas Monitoring Requirements
SAMPLE COLLECTION YEAR 2 a 19
SAMPLE PERIOD ❑✓Tan -June ❑ July -Dec
or ❑ Monthly' /month)
ROFCDO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
C ❑Zero -flow ❑Water Supply ❑SA
JUL 2 8 2019 ❑other
CENTKAL
SECTION HILESPLEASE REMEMBER TO SIGN ON THE REVERSE
DWRNt o discharge this period'
Outfalf
Date
, SaimpledCollectecl,
:,,mo'J,d87yr I
00530'
00400
00556
Total Suspended
Solids,mgJL,
pH,
.Standard units
Non -Polar Oil and Grease/TPH EPA
Method:1664;(SGT'HEM), mg/L
New Motor Oil Usage,
Annual average galJmo
Berictima k7.I
50:or,100seepeiniii
Within6i0-9.0
15
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
:,Outfall':
No.
,'-��• .a,-*`,ino`Jdd`/,y"�z
-. tDate,- .: "'-•,'
<' f4
Sample Collected 1!
'_': 00556 00530
00400
Non Polar Oil:and Grease/TPH EPA Method Total Suspended Solids,
��-.�-•.�,1664"(SGT`HEM),.mgJL=�`.'r-- _' :�?:f' `:nig/L-�. '--L- .,�
pH,
"5tand'a�dl'units
Permit Limit"
' ` ' it
`S " :15, 50'or 100 see—.perniit
6.0-9.0
i
i For sampling periods with no discharge at any single outfail, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last ravised October 25, 2012

STORM EVENT CHARACTERISTICS:
Date (first event sampled)
Total Event Precipitation (inches): _
Date (list each additional event sampled this reporting period, and rainfall amount)
q Total Event Precipitation (inches):
Note: 'if y}au 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 OUTPALL 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 7 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 lob 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 ail attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personn properly gather a d evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible ` rgathering the i �mation, the information. submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that
there are significa ena ies for sub itting false information, including the possibility of fines and Imprisonment for knowing violations."
7/17(9
tct....� .e ,. o•.o,tt�ml (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/`wq/ws/­sulnl)dessw#tab-4
S4 L -250 last revised October 25, 2012
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