NCG080057_MONITORING INFO_20141020

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT N0.
/V CC b � � L 5 �
DOC TYPE
❑HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ C30 I q IO
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted /46// _
CERTIFICATE OF COVERAGE NO. NCGO8 O 0 5 q-
FACILITY NAME G1_ MiSor Sktildin j Com
COUNTY �rede_l4
PERSON COLLECTING SAMPLES D�,"r IY1 i llsVL S
LAB 0RATO_RY_S+giesv1'ile Aml 4; ca( Lab Cert. #
Comments on sample collection or analysis:
Part A: Vehicle Maintenance Areas Monitoring Requirements
SAMPLE COLLECTION YEAR 2-01q
SAMPLE PERIOD ❑ Jan -June July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply [:]SA
RECEIVED ❑Other
OCT 2 0 2014 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
CENTRAL FILES ❑ No discharge this period'
DWR SECTION
Outfall
No.
Date
Sample Collected,
mo/dd/yr
'00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average'gal/mo
Benchmark
-
50 or 100 see permit
Within 6.0 — 9.0
15
n -
9 2q liq
1215
< S , 2FIECEIVIm
!� T
�r I !a
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no
(if yes, report your analytical results in the table immediately below)
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals
CENTRAL FILES
DWR SECTION
Outfall
No.
Date .
Sample Collected,
mo/dd/yr
00556
00530
00400.
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0-9.0
t For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-230 last revised October 25. 2012
Page 1 of

STORM EVENT CHARACTERISTICS:
Date `� 2� I I� (first event sampled)
Total Event Precipitation (inches): .AW
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Nott,: 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 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 B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY O;VE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ r
REGIONAL OFFICE CONTACT NAME:
Mail on 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 monitoring period in
the rase of "No Discharge" reports) 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, Dr those persons
directly responsible for gathering the information, the iniormation 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."
(Signattfre of Permi
lllal/
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
S NVU-250
last revised October 25. 2012
Pay-e 2 of 2