NCG030305_COMPLETE FILE - HISTORICAL_20190619

• - - STORMWATER DIVISION CODING SHEET .-
RESCISSIONS .
PERMIT NO.
j�l �y . U �Jti.3 0 S
�s
DOC TYPE
COMPLETE FILE'- HISTORICAL
DATE OF
.RESCISSION
❑ a � � � ()V I
YYYYMMDD

Storm_water Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG030000
Date submitted2�19
CERTIFICATE OF COVERAGE NO. NCG03 0 3 o S SAMPLE COLLECTION YEAR Z0I9
FACILITY NAME & har+-Te_Vno6G4 LC ,fhA ', -� �c {yu�� SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
COUNTY _fin I_!n or ® Monthly- rVlvL4 (month}
PERSON COLLECTING SAMPLES L"%o1G - observes DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY N JA _ _ Lab Cert. # 0 RECEIVED ❑zero -flow ❑Water Supply [_]SA
Comments on sample collection or analysis: ®Other G
ls.,JOoI_6ktk C-OAQA7D JUL 01 2019
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
CENTRAL FILES
Part A: Stormwater Benchmarks and Monitoring Results DINR SECTION
No discharge this period?z
flutfall No.
Bate Sample
Collected-
Imo/dd/yrj
24-haur rainfap
amount,
Inches3
Total Suspended Solids
pH,
Standard units
Total Copper
Total Lead
Total Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics5
Benchmarks
_
-
100 mg/L or 50 mg/0
6.0 — 9.0
0.010 mg/L
0.075 mg/L
0.126 mg/L
15 mg/L
1 mg/L
Parameter Code
-
46529
C0530
00400
01119
01051
01094
00552
78141
F�
'Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same out -fall.
2 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, Section B, Table 1 to identify the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018
Page 1 of

�
Facilities thzt incorporate a solvent management plan into the Stormwater 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
(T€O), 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 rainfall 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 Stormwater Pollution Prevention Plan."
N1 a
Name (Print name)
N�A
Title (Print title)
"U
Signature
0
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, they must be reported in the format, "<XX me/L,,, where XX is 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 Tier 3 responses. See General Permit text.
Part 13: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
El No discharge this period ?2
Outfall No.
Date Sample Collected'
(mo/dd/yr)
24-hour rainfall amount,
Inches,
New Motor Oil or
Hydraulic Oil Usage
Non -Polar O&G/ Total
Petroleum Hydrocarbons
Total Suspended
Solids
Benchmarks
-
-
-
15 mg/L
100 mg/L or 50 mg/L_°
Parameter Code
-
46529
NCOIL
00552
C0530
Footnotes from Part A also apply to Part B
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: 11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018
Page 2 of 3

FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION 8.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER ATANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR, including all "No Discharere" reports, within 330 days of receipt of the lab results (or at end a} monitoring period in the
case of "No Dischar e" re arts to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CgRTIFiCATION 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 directLv responsible for gathering the information, the information submitted is, to the best of my Knowledge and belief, true, accurate, and complete. I
am aware th 9WAre,4gnificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Permittee
Permit Date: 11/1/2018-05/31/2021
Date
SWU-245, last revised 11/1/2018
Page 3 of 3

ik'�r..rr
Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG030000
Date submitted J'Iml 9
CERTIFICATE OF COVERAGE NO. NCG03 Q� �i SAMPLE COLLECTION YEAR AIR
FACILITY NAME `1 SAMPLE PERIOD ❑Jan -June ❑July -Dec
or Monthlyl n month
PERSON COLLECTING SMPLES NIA—_ COUNTY T}NG_ DISCHARGING TO CLASS ❑ORW HQW ❑Trout ❑PNA
PERSO
LABORATORY Lab Cert. # — �-Fte ❑Zeh�flow []Water Supply ❑SA
�' } 6 C.
Comments on sample collection or analysis: D
JON 2 20 19 PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
pi,
Part A. Stormwater Benchmarks and Monitoring Results ��
No discharge this eriod?2
Outfall No.
Date Sample
Collected'
(mo/dd/ }
24-hour rainfall
amount,
Inch&
Total Suspended Solids
pH,Non-Polar
Standard units
Total Copper
Total Lead
Total Zinc
O&G/7otai
Total Petroleum
Hydrocarbons
Toxic
Organics;
Benchmarks
-
100 mg/L or S0 mg/0
6.0 — 9.0
0.010 mg/L
6.075 mg/L
0.126 mg/L
15 mg/L
1 mg/L
Parameter Cade
-
46529
C0530
0040D
01119
01051
D1094
00552
78141
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark 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, Section B, Table 1 to identify the especially sensitive receiving water classifications where the more protective benchmark applies.
S Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found In 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date- 11/1/2018-05/31/2421 SWU-245, last revised 11/1/2018
Page 1 of 3

r77
Facilities tnaf incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement forTTO monitoring
may be waived. The solvent management plain 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 fallowing 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
(TTO), 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 rainfall 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 Stormwater Pollution Prevention Plan."
01 Q
Name Print name)
Title [Print ti
1
)�24. !Z_%)1n
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, they must -be reported in the format "<XX ma/L", where XX is 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 Ter 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?2
Outfall No.
Date Sample Collected'
(mo/dd/yr)
24-hour rainfall amount,
inches'
New Motor Oil or
Hydraulic Oil Usage
non -Polar O&G/ Total
Petroleum Hydrocarbons
Total Suspended
Solids
Benchmarks
-
-
].5 mg/L
100 mg/L or 50 mg/L°
Parameter Code
-
46529
NCOIL
00552
C0530
Footnotes from Part A also apply to Part B
Note: If you report a sample value In excess of the benchmark you must implement Tier I, rer 2, or Ter 3 responses. See General Permit text.
Permit Date: 11/1/2018-05/31/2021 SWu-245, last revised 11/1/2018
Page 2 of 3

FOR PART A ANDPARIBIVIONITORINGRESULTS:
+ A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART it SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART If SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER ATANY ONE OUTFALL7 YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal coot+ of this DMR, includina all "No Discharge" reports, within 30 dogs of receipt of the lab results (or at end of monitorina period in the
case of "No Discharae"reports) to:
DMsion 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 responsible fo athering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that there are sfg a P §1(ies for submitting false Information, including the possibility of fines and imprisonment for knowing violations."
� Lin
-x --_ V
3�
Signature of Pe�mittee Date
Permit Date:11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018
Page 3 of 3