NCG160172_MONITORING INFO_20200123

MZv
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ c d a b b Q 3
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Per 't No. NCG160000 - Asphalt
Date submitted '
CERTIFICATE OF COVERAGE NO. NCG1601 ]—2-
FACILITY NAME 1 11���t� Cq iccQ
COUNTY Gf'�S3ARt�—V S
PERSON COLLEC�NG SAMPLES • C tTTr
LABORATORY +'F4450-k Lab Cert. # !ice
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Q01f
SAMPLE PERIOD ❑ Jan -June July -Dec
or ❑ Monthly' /month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply []SA
®Other (!LAf�55 C
❑ No discharge this period?'
Outfall No.
1
Date Sample
Collected i
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Total Suspended Solids
Benchmarks =__>
-
100 mg/L or 50 mg/L'
RECE�.
34N 2 a
G $_G'f pN
' 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 3, 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, quantitation limit, etc. in mg/L.
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: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. N//q
❑ No discharge this period?Z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L4
Footnotes from Part A also apply to this Part B
M��
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 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 ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one coPv 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 Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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."
iazohl
(D e)
Permit Date:10/1/2014-9/31/2019
SWU-252, last revised 9/17/2014
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000 - Asphalt
Date submitted �� O / �� (�}
CERTIFICATE OF COVERAGE No. NCG16 b l 7 2- SAMPLE COLLECTION YEAR O ` s
FACILITY Ary ME IiL� - SAMPLE PERIOD ❑ Jan -June ;K July -Dec
COUNTY lr_US or ❑ Monthly' (month)
PERSON COLLECTING SAMPLES CC A• CAfTTY DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY ff-4_C A, Lab Cert. # y/� _ Zero -flow ❑Water S�uC_ppply [:]SA
� Other L:_L-o
Comments on sample collection or analysis
Part A: Stormwater Benchmarks and Monitoring Results
Ef No discharge this period?z
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total Suspended Solids
Benchmarks ===>
_
-
100 mg/L or s0 mg/L
D
b
RFCEIVr--
JAN 2 3 2` 1
c;6NTRAL F' i_
DV\FR SECTIaIll
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 3, 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, quantitation limit, etc. in mg/L.
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: 10/1/2014-9/31/2019
SWU-252, last revised 9/17/2014
Page 1 of 2

rt Y: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. 14/A
n No dischorae this oeriod?2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =__>
_
-
15 mg/L
100 mg/L or 50 mg/L
ltnotes from Part A also apply to this Part B
/k/p Il�syfl C��
te: 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.
I 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 DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑
;IONAL OFFICE CONTACT NAME:
iil 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 mor:::2itorinc8� period
he case of "No Discharge" reports) to:
ision of Water Resources
is DWR Central Files
.7 Mail Service Center
nigh, North Carolina 27699-1617
ertify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
ire that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
se persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and c®rnplete_
aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
nature of Permittee)
mit Date: 10/1/2014-9/31/2019
io /`1
(Date)
SWU-252, last revu sed 9/3- 7/2014
Page 2 of 2