HomeMy WebLinkAboutNCG100127_MONITORING INFO_20141014STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
IV C(
DOC TYPE
❑HISTORICAL FILE
�. MONITORING REPORTS
DOC DATE
❑ a 0 1N I D J
YYYYMMDD
•
LJ
Ag A
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling ow this fonn, please visit: http://portal.ncdenr.orp/web/wg/ws/su/npdessw#tab4
Permit No.: NICI 1 I 1_I_I l 1 rr Certificate of Coverage No.: NIC/GI ITh1_l 1_I
Facility Name: f 4 L S k, i' �a r
County: �---1 Yet n i1 U Phone No
Inspector: 0��-k -e.. It
Date of Inspection: +I — 1 f
Time of Inspection: (� t 41? ►�f
Total Event Precipitation (inches):
0( C;' 9--
Was this a Representative Storm Event? (See information below) Yes ❑ No
Please check wmr pennil io verif v if Qualilrrrive Moniloring musi he pei fiwmed during rr rel�reseruaPit c
slorm event (regrrirernenis tern v).
A "Representative Storm Event" is a storm event that measures greater than 0. l inches of rainfall and that
is preceded by at least 72 hours Q days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signature, I certify that this port is accurate and complete to the best ol' my knowledge:
A .4
(Signatuo of Permittee or Designee)
1. Outfall Description:
Outfall No. Structure (pipe. ditch, etc.) c� ,
LcA—
Receiving Stream:
Describe the industrial activities that occur Within the outfall drainage area:
2. Color: Describe the color of the disclr r le using sic colors (red, brown, blue, etc.) and tint
(light. medium, dark) as descriptors:OC-
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): A%b n.P.
Page I of 2
S WU-242-20120013
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
' and 5 is very cloudy:
Cif 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where l is no solids and 5 is the surface covered with floating solids:
E1 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
] 2 3 4 5
7. Is there any foam in the stormwater discharge? . Yes (;
S. Is there an oil sheen in the stormwater discharge'? Yes o
i
9. Is there evidence of erosion or deposition at the outfail? Yes No
9 1(}. Other Obvious Indicators of Stormwater Pollution:
•
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may
he indicative of pollutant exposure. 'These conditions warrant further investigation.
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SwU-242-20120613
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
CERTIFICATE OF COVERAGE NO. NCG100 _1_ _2_ _7_ YEAR: 2014
����i hl s Unitoring report shall beAMPLES COLLECTED DURING Areceived Rby the Division no later than 30 days
a� r 4from the date the facility receives the sampling results from the laboratory.)
2014
FACILITY NAME Nine's Auto Parts CENTRAL FILES COUNTY Wake
PERSON COLLECTING SAMPLE(S) Jamie Gilkes r` VVR SECTION PHONE NO. (_919_) 832-9549
CERTIFIED LABORATORY(S) Test America Pensacola Lab #_314_
Lab # PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results
For sampling periods with no discharge, you must submit this discharge monitoring form noting "No Flow" or "No Discharge" within
30 days of the end of that period to comply with permit reporting requirements.
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 in the General
Permit.
1See If pH values outside this range are recorded in sampled stormwater discharges, but ambient precipitation pH levels are lower, then the lower threshold of this benchmark
range is the pH of the precipitation (within instrument accuracy) instead of 6 S.U. Readings from an on -site or local rain gauge (or local precipitation data) must be documented
to demonstrate background concentrations were below the benchmark pH range of 6-9.
2
See General Permit text to identify whether the more protective benchmark applies for especially sensitive receiving waters.
3For purposes of this permit the definition of Total Toxic Organics is that list as stated in Appendix D, Table II of Chapter 40 Code of Federal Regulations (CFR) Part 122.
Form SWU-251, last revised October25, 2012
Page 1 of 2
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
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:
Solvent Management Plan 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),
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 all the provisions of the solvent management plan
included in the Stormwater Pollution Prevention Plan."
Name (Print name)
Tit rint title) �
Signature
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
_,ps -/r/-
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.
am aware -that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
r
(Signaturefgf Permittee or Desi
g t ,A;�4T
(Date)
Form SWU-2S1, last revised October25, 2012
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