NCG020097_MONITORING INFO_20160223

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V olc� � � /
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ Q �) I b oa a'J
YYYYMMDD

ANNUAL SUMMARY DNTR - STORMWATER
If SEND TO CENTRAL OFFICE * 11
STORMWA TER DISCHARGE OUTFALLS (SDO)
GENERAL PERMIT NO. NCG020000
*Report ALL STORMWA TER Monitoring Data on this form(including No Flow and No Discharge and Permit Limit Violations by MARCH 1 of each F—GEIYp
CERTIFICATE OF COVERAGE NO. NCG02_ _p
FACILITY NAME: j*k !j , s+twc ,� ayr4rtKy
►
PERSON COLLECTING SAMPLES njj.L-
CERTIFIED LABORATORY ej}L1` Lab # Ha
Lab #
Part A: Stormwater Monitorin Requirements
SAMPLE COLLECTION YEAR: 20 IS
COUNTY AIAICP 1,✓
PHONE NO. CYALP) L !U - 3 jfV y
ADD TO LISTSERVE? YES ❑ NO ❑ EMAIL:
FEB 2 3 2016
CENTRAL FILES
DIAJR SUCTION
0utfall
No.
Date Sample
Collected
(molddlyr OR
NO FLOW)'
In Tier 2
Monthly
�
Monitoring.
(yln)
# of Months in
Tier 2
Sampling 2
Total Flow
(MG)
Total Suspended
Solids
(mom)
Turbidity
(NTU)
Settleable
Solids (ml/l)
Total
Rainfall
(in)
Event
Duration
(minutes)
-
-
-
-
-
1003�'
See Footnote 3, s
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if "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here and the Date Range.
7 Per NCG02: Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
' If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit.
a TSS benchmark values are 100 mg/l except in ORW, HWQ, trout, and PNA waters where they are 50 mgll.
'The discharge shall not cause an instantaneous measurement of the turbidity of the receiving water to exceed: 10 NTU for freshwater streams, lakes, and reservoirs designated
as trout waters, 25 NTU for all lakes and reservoirs. and all salt waters, 50 NTU for all other streams and surface waters. Turbidity may be monitored at the SDO.
Alternatively, the permittee may choose to monitor turbidity in the receiving water, directly upstream and downstream of the SDO.
Permit Date: 1/l/2010-12/31/2014 Last Revised 02-02-11
Pagel of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month on average
Outfall
No
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
Sampling'
New Motor
Oil Usage
allmonth
Total Flow
(MG)
TPH using method
1664A SGT-HEM
m
Total Suspended
Solids
m 1
pH
(Standard
Units
Total
Rainfall
in
Event
Duration
minutes
153
1003.4
6-93
S
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7.3
14
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1/14/11
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HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO R
WHO AT THE REGION HAVE YOU SPOKEN WITH?
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE" & LIMIT
VIOLATIONS) BY MARCH l OF EACH YEAR TO:
Division of Water Quality
Attn: DWQ Central Files
t617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERTIFICA TION 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."
(Signa,yffe of Permittee)
Permit Date: l/l/2010-12/31/2014
rZ S
(Date
Last Revised 02-02-11
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