NCG160012_MONITORING INFO_20200121

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
(- G
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ �� 1
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted Of r'lv /2e zo
CERTIFICATE OF COVERAGE NO. NCG16 0012 SAMPLE COLLECTION YEAR Year 1 Period 2
FACILITY NAME Fred Smith company- Wake Forest Plant SAMPLE PERIOD ❑■ Jan -June ❑ July -Dec
COUNTY wake `, or El monthly' (month)
PERSON COLLECTING SAMPLES Austin Pore REGE �i MiSCHARGING TO CLASS ❑ORW ❑HQW [:]Trout❑PNA
LABORATORY ENco Lab Cert. ff c31704-9 BAN 21 2�2� ❑Zero -flow ❑Water Supply []SA
Comments on sample collection or analysis: *Other class WS-iv; NSW
None GCNTRkL FILES
Dytt(1 EC710N PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results
No discharge this period?'
Outfall Na.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Total Suspended Solids
Benchmarks =__>
-
100 mg/L or 50 mg/L"
001
01/03/2020
0.86
30
'Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a check mark here.
3The 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, quantitation limit, etc. in mg/L.
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.
Permit Date: 08/01/2019-05/31/2024 SWU-252, last revised 09/04/2019
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
New Motor Oil or Hydraulic
Oil Usage, Annual average
gal/mo
Benchmarks =__>
15 mg/L
100 /L or 50 mg/O
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, Ter 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DEMUR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO 0
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this OMR Includina 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 Resources
Attn: DWR 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."
(/`f 2oZ0
(Date)
Permit Date: 08/O1/2019-05/31/2024 SWU-252, last revised 09/04/2019
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