NCG080201_MONITORING INFO_20200127

WSZ/d
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
()Vo J L) I
/V
DOC TYPE
❑HISTORICAL FILE
V\MONITORING REPORTS
DOC DATE
❑ �oc)- 0 t a
YYYYMMDD

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG080000
Date submitted e11,5-1,��
CERTIFICATE OF COVERAGE No. NCG08 a 2 o ,
FACILITY NAME i4rc)b izaas s�
COUNTY faRsv;�l
PERSON COLLECTING SAMPLES L�ns� sl
LABORATORY Lab Cert. # alp
Comments on sample collection or analysis:
.:C)
SAMPLE COLLECTION YEAR -tatiq
SAMPLE PERIOD ❑ Jan -June July -Dec
or El Monthly' P (month)
��C Sr-WfIGING TO CLASS ❑ORW ❑HCtW ❑Trout ❑PNA
�QN 2 '��----LL..JJ ❑Zero -flow ❑Water Supply ❑SA
2020 ❑Other
C-!zN7RAL Flf,f`S
PLEASE REMEMBER TO S1GN ON THE REVERSE
GV' R SEC-rlo1
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? t� yes ® no (if yeIS complete Part A)
Part A, Vehicle & Equipment Maintenance Areas Monitoring Requirements (if applicable) LN No discharge -this period'
Outfall No:
Date Sample Collected'
(mo/dd/yr)
' 24-hour rainfall+amount,'
Inches' .
Non-Polar Oil & Grease
mg/L
Total Suspended Solids,
mg/L
New Motor or Hydraulic Oil Usage,
-gal/mon
Benchmarks.
_
1s
100 or SO4
-
Parameter Code
-
45529
005S2
C0530
NCOIL
Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3-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.
4 See General Permit text, Table 1, 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 mg/L", where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">Xx".
Permit Date: 11/1/2018-5/31/2021 5WU-248, last revised 11/1/2018
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Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) ❑ No discharge this period2
Outfal!
No.
Date Sample
Collected'
mo dd r
24-hour rainfall
amount,
Inch63
Sample Collected'
mo/ddlyr
Total Suspended
Solids,
m gl ..
pH,
Standard units
Non Polar Oil &
Grease,
..
m g/L-
Permit'+Lrri�r# 1 �; '
100 Qc 504
6.0'79.A
: 15
P,•arame`terCader
46529
-
C0530
:.00400
00552;. .
Footnotes from Part A also apply to this 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.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 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 B.
• 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 DEMLR REGIONAL OFFICE? YES ® NO
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR,'includinq all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitorina period in the
case 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, 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."
Signatuk cijPermittee
Date
Permit Date: 11/1/2018-5/31/2021
SWU-248, last revised 11/1/2018
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