NCG100073_MONITORING INFO_20151020

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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v U b O ,
DOC TYPE
❑HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ ��15i�
YYYYMMDD

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG100000 SAMPLES COLLECTED DURING CALENDAR YEAR:
CERTIFICATE OF COVERAGE NO. NCG10 QQP7 (This monitoring report is due at the Division no later than 30 days from
the date the facility receives th s mpling results from the laboratory.)
FACILITY NAME CA COUNTY c
PERSON COLLECTING SAM ES PHONE NO.
CERTIFIED LABORATORY in Lab # y
0. Sj -Wo, Lab # PLEASE SIGN ON THE REVERSE 4
Specific Monitoring Requirements:
0, LQ0530 .
«'>w,W�
e
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Ai
7AR
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:...:No
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Sample Collected,
,.t �. Pv d
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�Total:Suspended ,
.0 o,!"''"Si
:,�{ 7l' .ei' f a± _.ti 3>.u'�i
� Solids„�.
ts*:p
.x-.�'�,. n �... rRY,-.-ha;-
FiY. Yl � Fel
,Lea d, Total
_>1 :S - '.
Oil and re.
G ase,
pup. r_;•yi
4, '7Y. V PO S.._4'
�ng/L_
Total Toiuc
<<s ✓a m`
-. F aT.iLj�4
�
�+ ene.Glycol, ,
r
4 r �
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malddlyz, b
f r:. r .�., ��tu•
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_ --dardfuntts
,+ kk_r� - �y:
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,.Recoverable;
.
�• '.�l'� : �`'� x
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34��
.,� a .Organics},
7
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c.. vi%- �4- E;' _ ,. '��
"���.�.�,,,100,Y �.,��
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Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses. '
See General Permit text.
STORM EVENT CHARACTERISTICS:
Date (first event sampled)
Total Event Precipitation (inches): _
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Mail Original and one copy to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
S WU-251-102107
Pagel of 2

1 For purposes of this permit the definition of Total Toxic Organics is that list as stated in Appendix D, Table 11 of Chapter 40 Code of Federal Regulations (CFR) Part 122.
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may request that DWQ waive monitoring of total toxic organics. 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 allowed such a 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 (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 stornwater
runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing all the provisions of the solvent management plan
included in the Stormwater Pollution Prevention ]an."
Name not name) -
Tit P ' t title) l
( ignatur (Date)
"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."
�,9 It5l
(D te)
S WU-251-102107
Page 2 of 2

1 � y
0 W A7t4
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Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
RECEIVED
OCT 21 2o15
CENTRAL. FILES
DWR SECTION
Permit No.: NICI ill or Certificate of Coverage No.: NIC/G1L1_ 1Q1f2111_3
Facility Name:
County: V Phone No. ,4T( — 3_2 00(0
Inspector: D2 L&gq 13 47 Lhtnn"k
Date of Inspection: _ Q -�,?,1 = /$_
By this signature, I certify that this re rt is accurate and complete to the best of my knowledge:
Si )iature of Permittee or Designee)
1. Outfall Description
Outfall No. l Structure (pipe, ditch, etc.) UJLi LjPct t,�_ VAC_ V1
Receiving Stream: C e_ Pam'x.-- (Ej'i
Describe the industrial activities that occur within the outfall drainage area: C—CA
Color
Describe the color of the discharge using basic colors (red, brown, blue, etc:) and tint (light, medium,
dark) as descriptors:
3. Odor
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.)
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
1 2 0 4
5 6 7 8 9 lD
Page I
S WU-242-020705

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
I is no solids and I0 is the surface covered with floating solids:
1 2� 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
1 0. 3 4 5 6 7 8 9 10' '
r
7. Foam
Is there any foam in the stormwater discharge? Yes . No
S. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes No
i
9. Deposition at Outfall
Is there deposition of material (sediment, etc.) at or immediately below the outfall? Yes No
10. Erosion at Outfall
Is there erosion at or immediately below the outfall? Yes No
11. Other Obvious Indicators of Storrriwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion may be
indicative of conditions that warrant further investigation and corrective action.
Page 2
SWU-242-020705

RESEARCt1& ANA1-YTiCA[ •�'�� '�...hft
LAboRAT®RI E5, INC. NC#U
Analytical/Process Consultations 't c
CTe
Chemical Analysis for Selected Parameters and Water Sample Identified as Stormwater
(A Projector Wheely Auto Mall, collected 25 September 2015)
I. EPA Method
Quantitation
8015
Limit
Parameter
(m2/L)
(ms/L)
Ethylene Glycol
10.0
BQL
II. Miscellaneous
Quantitation
Limit
Parameters
(mslL)
(mp,/L)
Lead, Total
0.005
BQL
Oil R Grease, Total
5.0,
BQL
TSS
5.0
7.0
III. Miscellaneous Quantitation
Limit
Parameters (SU) isul)
pH N/A 6.11
Sample Number 9686-01
Sample Date 09/25/15
Sample Time (hrs) 0824
r'3
10

RESEARCh & ANA[yTICA[
LAbORATORIES, INC.
Analytical 1 Process Consultations
Phone [phone]
COMPANY
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JOB NO.
STREET ADDRESS
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SAMPLER NAME (P SE PRIf
CONTACT
PHONE SAMPLER SIGNATURE
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DATEMME RECEIVED BY
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REMARKS:
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SAMPLE TEMPERATURE AT RECEIPT • b °C
9ELIAQUISHED BY
DATEffME RECEIVED BY
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