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Facilities that incorporate a solvent management plan into the 5tormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
iTTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to ralnfail or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the 5tormwater pollution Prevention Plan,"
15�lr
Name {Print n e}
Title {Print tit)
Signature Date
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, ¢PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, rh_ ev must pe re arced En the format, "rxx mg/!', where Hx +s the numerical value of the detection
limit, reporting 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 Tfer 3 responses. See General Permit text.
Park B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
No dischorge this period
❑utfall No. 1 Date Sample Collected)
(mo/dd/yr)
Benchmarks
Porameter Code
Footnotes from Part A also apply to part B
24-hour rainfall amount, I New Motor Oil or
lnches3 Hydraulic Oil usage
46529 1 NCOIL
Non -Polar 0&G/ Total
Petroleum Hydrocarbons
Total suspended
Solids
15 mg/L
100 mg/1 or SO mgJL4
00552
C0530
Note: if you report a sample value in excess of the benchmark, you must implement Tier I, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2018.05/31/2D21
SWU-245, last revised 11/1/201g
Page 2 of 3
FQ_ R PART A ANp PART B MONITSRING 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 .
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDB.
ENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ®ND ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ No ❑
REGIONAL OFFICE CONTACT NAME:
Mail an arl lnalta a this QMR includi f all "No Dischar e" re arts within 30 da eL o recef t o the lab results far at end of monitarina period fn the
case o IYo Ulscharae"renartsl 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 esponsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that ther re significant penalties for submitting false information, Including the possibility of fines and imprisonment for knowing violations."
Signature Permittee
Date
Permit Date:11/1/2018-05/31/2021
SWU-245, last revised 11/1/mB
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