NCG080257_MONITORING INFO_20140929

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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
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DOC TYPE
[I HISTORICAL FILE
C� MONITORING REPORTS
DOC DATE
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YYYYMMDD

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Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted 31 l it
CERTIFICATE OF COVERAGE NO. NCG08 0 `J I
FACILITY NAME ✓3�
COUNTY C5,AS40 tJ
PERSON COLLECTING SAMPLES ke, Q i
LABORATORY V,e 5ecty L', 4 fVAn1V ti Lab Cert. #
Comments on sample collection or analysis:
___ _.,�jn'(-Jyls_
SAMPLE COLLECTION YEAR
SA
MPLE PLEPERIOD �C] Jan -June July -Dec
RECEIVED
or ❑ monthly' month
SEP 2 9DlbC ARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
UU II []Zero -flow ❑Water Supply ❑SA
CENTRAL FILES ❑Other
DWR SECTION
PLEASE REMEMBER TO SIGN ON THE REVERSE 3
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yes -
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530 -
00400
00556
Total Suspended.
Sallds,:mg/L
= pH,
5tandaF4 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, ermit*
_Within 6A = 9.0
Z5. _
-
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Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfal!
No.
pate
Sample Collected,
t .. mo/dd/yr.
00556
00530- . :.
00400
Non -Polar oil and'Grease/T'PH EPA Method '.
1664 (SGT'HEM),:mg/L
:Tots! Suspended Solids",:--`
x - mg/Lw- '
pit,' _
;Standard units.
Permit Limit.
"J'So or! 100 see'permit
6.0 — 9.0
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
Sti1'l:-250 last revised April 11. 201
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STORM EVENT CHARACTERISTICS:
Date 61alf (first event sampled)
Total Event Precipitation (inches): 0s
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches): z
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 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 a OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one cony of this DMR. including all "No Discharge" reports. within 30 days of receipt of the lab results !or at end of monitoring period in
he case o "No Discharge" re orts to:
Division of Water Quality
Attm 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 pgnalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
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nature of Pe
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(pate) r
Additional copies of this form may be downloaded at: http:l/portal.ncdenr.org/web/wqlws/su/npdesswtttab-4
S\1 U- 4;0
last revised April 11. 2013
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