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NCG120042_MONITORING INFO_20190513
STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. /vC� DOC TYPE ❑HISTORICAL FILE 4 MONITORING REPORTS DOC DATE rl c� 0 1 5 b 5 i 3 YYYYMMDD Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG120000 CERTIFICATE OF COVERAGE NO. NCG12 0 0 4 2 FACILITY NAME fredell County Solid Waste Facility COUNTY Iredell Date submitted 5i6i19 SAMPLE COLLECTION YEAR 2019 RECEIVE[[ AMPLE PERIOD Q Jan -June ❑July -Dec PERSON COLLECTING SAMPLES Ronald Browning MAY 3 Zmin LABORATORY Statesville Analytical Lab Cert. # 440 CENTRAL_ i=1LES; Comments on sample collection or analysis: DWR SECTION' Part A: Stormwater Benchmarks and Monitoring Results or ❑ Monthly' (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA ❑Zero -flow ❑Water Supply ❑SA ❑■ Other PLEASE REMEMBER TO SIGN ON THE REVERSE 4 ❑ No discharge this period Outfall No. Date Sample Collected Imo/dd/yr) 24-hour rainfall amount, Inches3 Chemical Oxygen Demand mg/L Fecal Coliform Colonies per 100 mL Total Suspended Solids mg/L pH, Standard Units Benchmarks _ - 120 1000 100 or 504 6.0-9.0 Parameter Code - 46529 00340 31616 CO S30 00400 1 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. 3The 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. a 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 me/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". 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. Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this periodz 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 504 — Parameter Code - 46529 00552 C0530 NCOIL SD07 4/12/19 .5 9.6 41.33 65 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 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 ONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an oriainal copv of this DMR, including all "No Discharae" 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. am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." Signature of Permittee /(a f I I Date Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG120000 Date submitted 12/27/2018 CERTIFICATE OF COVERAGE NO. NCG12 0 0 4 2 FACILITY NAME Iredell County Solid Waste Facility COUNTY Iredell County PERSON COLLECTING SAMPLES Ronald Browning LABORATORY Statesville Analytical Lab Cert. # 440 Comments on sample collection or analysis: Follow-up after improvements for FC exceedances Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2018 SAMPLE PERIOD ❑ Jan -June ❑i July -Dec or ❑ Monthly' (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA RE EE i ED ❑Zero -flow ❑Water Supply ❑SA JAN 0 3 2019 QOther CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4 DWR SECTION ❑ No discharge this period2 Outfall No. Date Sample 1 Collected (mo/dd/yr) 24-hour rainfall amount, Inches' Chemical Oxygen Demand mg/L Fecal Coliform Colonies per 100 mL Total Suspended Solids mg/L pH, Standard Units Benchmarks _ - 120 1000 100 or 50' 6.0-9.0 Parameter Cade - 46529 00340 31616 C0530 00400 SD051 12/11/2018 1.5 <25 53 22.222 7.31 SD052 12/11 /2018 1.5 <25 47 24.889 7.27 SDO55 12/11 /2018 1.5 <25 45 28 7.54 1 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. 3The 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". 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. Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑® No discharge this periodz 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 _ - 15 100 or 504 — Parameter Code - 46529 00552 C0530 NCOIL Footnotes from Part A also apply to this Part S Note: if you report a sample value in excess of the ,benchmark, you must implement Tier I, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART 8 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 ANYONE 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, including all "No Discharae" reports, within 30 days of receipt of the lab results (or at end of monitoring 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." Signature of Permittee I -L 2- z9 I Date Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Energy, Mineral and land Resources General Permit No. NCG120000 Date submitted 1- d - :.o1 9 CERTIFICATE OF COVERAGE No. NCG12 O O FACILITY NAME Z--leff COUNTY rrtJ c [ I PERSON COLLECTING SAMPLES R�+�w-�c� �►w'-'� LABORATORY 44r_*v:(1e A%a�l ��wl Lab Cert. # q4 Comments on sample collection or analysis: -re(1oL-)-LA.jp 6C-L P1�f_ Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR a' D t Ir SAMPLE PERIOD ❑ Jan -June Vo July -Dec RECOVGD or []Monthly" (month) RECOVED TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA JAN 11 Z014 ❑Zero -flow ❑Water Supply (_]SA CF-NTf-<AL FILES U�jQther DWR SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE ❑ No discharge this period' Outfall No. Date Sample Collected 1 (mo/dd/yr) 24-hour rainfall amount, Inches' Chemical Oxygen Demand mg/L Fecal Coliform Colonies per 100 mL Total Suspended mg/L Solids pH, Standard Units Benchmarks _ - 120 1000 100 or 504 6.0-9.0 Parameter Code - 46529 00340 31616 C0530 00400 1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. 2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. '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". + 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. Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Non -Polar Oil & Grease mg/L Total Suspended Solids, mg/L New Motor or Hydraulic Oil Usage, gal/mon Benchmarks _ - i5 100 or SO' — Parameter Code - 46529 00552 C0530 NCOIL v o G.07_ L 5. Footnotes from Part A also apply to this Part B Note: If you report a sample value in excess of the benchmark, you mast 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 ONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT {NAME: Mail an oriainal copy of this DMR, includina all "No Discharge"reports, within 30 days of receipt of the lab results (or at end of monitoring 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." ___0 4--!� _.:� Signature of Permittee (J •_ 11 Date Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Resources General Permit No. NCG120000 Date submitted 12/312018 CERTIFICATE OF COVERAGE NO. NCG12 O 0 4 2 SAMPLE COLLECTION YEAR 2018 FACILITY NAME lredell county Solid waste SAMPLE PERIOD ❑ Jan -June ❑■ July -Dec COUNTY iredell Countv RECEIVI=n or ❑ Monthly' (month) PERSON COLLECTING SAMPLES Ronald Browning DISCHARGING TO CLASS ❑❑HQW [:]Trout❑PNA LABORATORY StatesvilleAnaylitical Lab Cert. ## 440 DEC 0 7 2018 ❑zero -flow ❑Water Supply [:]SA Comments on sample collection or analysis: CENT ❑■ Other fecal coliiorm due to wildlife (buzzard) activity at landfill using basins as drinking water source �i_ Fi��s C'wR SECTi'a,l PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Part A: Stormwater Benchmarks and Monitoring Results ❑ No discharge this period: Outfall No. Date Sample Collected (mo/dd/yr) 24-hour rainfall amount, Inches Chemical Oxygen Demand Fecal Coliform Total Suspended Solids Benchmarks =__> - - 120 mg/L 1000 count per 100 mL 100 mg1L or 50 mg/L° 51 11-9-18 1.5 26 4000 56.667 mg/L 52 11-9-18 1.5 32 7000 44 mg1L 53 11-9-18 1.5 <25 570 82 mg/L 54 11-9-18 1.5 <25 510 50.667 mg1L 55 11-9-18 1.5 <25 7500 41.667 mg1L 1 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. 3The 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. ° See General Permit text, Table 3, 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 me/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". 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. Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?2 Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inche53 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =__> _ - 15 mg/L 100 mg/L or 50 mg/L° 6.0 — 9.0 SU 7 11/9118 1.5 19.1 20 mg/L 6.71 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 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 ANYONE OUTFALL? YES ❑ NO ❑® IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an 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 in the case of "No Discharge" reports) to: Division of Water Resources Attn: DWR 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. am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." I a (Signature of Permittee) Permit Date: 11/1/2012-10/31/2017 1210312018 (Date) SWU-248, last revised 10/25/2012 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG120000 Date submitted (- zo t ? CERTIFICATE OF COVERAGE NO. NCG12 0 b 4 2— FACILITY NAME Z-(e(1 G'a=. !, 5.1"A alas �i COUNTY 7ve4Ar-(( - PERSON COLLECTING SAMPLES ROw_Ia 13n"w'% LABORATORY _96-f-s-Ile Lab Cert. q A440 Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR Ir SAMPLE,PERIOD [!]Jan -June ❑ July -Dec RECE IIF-I) or ❑ Monthly' month DISCHARGING TO CLASS ❑ORW ❑HQW []Trout❑PNA �' JUN 2 � Z� ❑Zero -flow [—]water Supply [_]SA CENTRAL [Other CV'JR, SECTiC,'' PLEASE REMEMBER TO SIGN ON THE REVERSE 4 ❑ No discharge this period?' Outfall No. Date Sample Collected (mo/dd/yr) 24-hour rainfall amount, inches Chemical Oxygen Demand Fecal Coliform Total Suspended Solids Benchmarks =__> _ - 120 mg/L 1000 count per 100 ml. 100 mg/L or 50 mg/L SAo s f S/►g r� •'15 �3 a,000 3a.•�r 5DO 54 5/15-/r5- 1 5 7GOnC) as n 5Do 6 5 51Ylr-r 5 Las 3ioo 4410,0 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. 3The 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. ° See General Permit text, Table 3, 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". 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. Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. n No discharge this period?2 Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches-' Non-polarO&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =__> - 15 mg/L 100 mg/L or 50 mg/L 6.0 — 9.0 SU Footnotes from Part A also apply to this Part 8 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 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 OUTFALLTRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCE5 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 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. am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) Permit Date: 11/1/2012-10/31/2017 (Date) SWU-248, last revised 10/25/2012 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for Notch Carolina Division of Water Quality General Permit No. NCG120000 Date submitted 3/a041c- _ CERTIFICATE OF COVERAGE NO. NCG12 D D 4 -1- SAMPLE COLLECTION YEAR 90 f fr FACILITYNAME Zrtdtlf 4::—4-1 SAMPLEPERIOD [-lan-June 0luly-Dec COUNTY 211eda If - - or ❑ Monthly' _ (month) PERSON COLLECTING SAMPLES Ro Nd14 Cr DISCHARGING TO CLASS ❑ORW ❑HQW [-]Trout ❑PNA LAl30RATORY 54zJftvtlle 6taayhfx.._I Lab Cert. It 4 `r 0 ' CEIVF-r��.-� ❑Zero -flow [:]WaterSupply [:)SA Comments on sample collection or analysis: [,Other MAR 2 9 2018 CENTRAL FILES DINR SECTION Part A: Storrnwater Benchmarks and Monitoring Results PLEASE REMEMBERTO SIGN ON THE REVERSE 4 ❑ No discharge this period?' outfall No. Date Sample Collected' I;mo/ddJyr) 24-hour rainfall amount, Irschias Chemical Oxygen Demand Fecal Coliform Total Suspended Solids Benchmarks ===s _ - 120 mg/L 1000 count per 100 mL 100 mg/L or 50 nig/L" ST) 0 f *3 -a 6 9- 7 to 000 -76 . 5 SDo ;-;E, 3 rx 1 . 3a 30 a50 70.9 5'00 S- 5/1 1Ir .30 34, rjeo ay.Coo 7 '- Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. 2For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 3The 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. ' See General Permit text, Table 3, 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 me/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". (Vote: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier3 responses. See General Permit text Permit Date: S1/1/2012.10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 PartB: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this periods Outfall No. Date Sample Collected} (mo/dd/yr) 24-hour rainfall amount, Inches3 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =__> _ - 15 mg/L 100 mg/L or 50 mg/O 6.0 — 9.0 SU 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: e 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 OUTFALLTRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART It SECTION B. e TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMM ARK 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 on orlainal and one coov of this DMR. includina all "No Discharae" reports, within 30 days of receipt of the lab results for at end of monitarinq_pedod in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27599-1617 YOU:MUST SIGN414IS CEiiTIFIGATION FOR ANY II`iFORiVIA7[ON REPoilttb: " 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 informatlon 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." (Signature of Permittee) Permit Date: 11/1/2012.10/31/2017 (Date) SWU-248, last revised 10/25/2612 Page 2 of 2 Semi-annual Stormwate_r Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No, NCG120000 Date submitted ,, vyc,.. t , I-ot�r CERTIFICATE OF COVERAGE No. NCG12 Vio 4 ?- FACILITYNAME zVe4t-ll Co6�,r,d t-1a3 -- COUNTY TQtcj-k f PERSON COLLECTING SAMPLES ROVIa( LABORATORY�4�v; &_ Awjr flca1_ Lab Cert. tt 1440 Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR Zo I 'r:� SAMPLE PERIOD NJan-June ❑ luly-Dec or ❑ Monthly' (month) REeV VAnjG TO CLASS ❑ORW ❑HQW []Trout ❑PNA ❑Zero -flow []Watersupply ❑SA MAR 0 B 2016 other c_k ass G CENTRAL RAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE -� DWR SECTION ❑ No discharge this period?' Outfall No. Date sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches Chemical Oxygen Demand Fecal Coliform Total Suspended Solids Benchmarks =_-> _ - 120 mg/L 1000 count per 100 mL 100 mg/L or 50 mg/L Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. 2For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 3The 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. A See General Permit text, Table 3, 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 me/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". !Vote: 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. Permit Date: 11/112012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 Part e: Vehicle Maintenance Area Monitoring Results; only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?' Outfall Na. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =_=> `0o _ 15 mg/L 100 mg/L or 50 m_ g/0 6.0 — 9.0 SU —7 007 l`r( • r75 S.fl 5 i,, 5 8, D 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: e A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. a 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION e. s TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE QUTFAI.L? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 dovs of receipt of the lab results (or at and of monitoring period in the case of "No pischorae" reports} to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YpU:MUST Sid-NJOIS CERTIFICATION FOR ANY 1NFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance Mth 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 lines and imprisonment for knowing violations." (Signature of Permittee) (Date) Permit Date: li/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG1.20000 Date submitted ?a ^ue►.. y 1 Z ZotV CERTIFICATE OF COVERAGE NO. NCG12 U FACILITY NAME Z•ta4-li C'-4--*SQ l: �• W �4f COUNTY 17Me_d4r_tt PERSON COLLECTING SAMPLES LABORATORY Lab Cert. p Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR ;�_ o t ~1 SAMPLE PERIOD ❑ Jan -June July -Dec or ❑ Monthly' (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA []Zero -flow ❑Water Supply []SA RECEIVED S.Qther JAN 25 2D18 PLEASE REMEMBER TO SIGN ON THE REVERSE -j CENTRAL FILES DWR SECTION PSNo discharge this period?' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, inches Chemical Oxygen Demand Fecal Coliform Total Suspended Solids Benchmarks =-_> _ - 120 mg/L 1000 count per 100 inl. 100 mg/L or50 mg/L" S'9o-5- 5 S_tl o- 5-- 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, ;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. ' See General Permit text, Table 3, 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, !Von -detect, ND, or other similar non - numerical format. When results are below the applicable limits, they must be reported in the format . "<XX me/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". !Vote: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier2, or Tier responses. See General Permit text Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page I of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks 15 mg/L 10o mg/L or 50 mg/L 6.0 — 9.0 SU 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 Tier3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: o A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART If SECTION B. c 2 EXCEEDANCES 1N A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALLTRIGGER T IER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. o TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FORTH E SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail on orlainal and one copv of this DMR, includina all "No Discharge" reoorts, withfn 30 days of recelpt of the lab results (or at end of monitorinq period in the case of "No Discharae" renortsl to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Y4U:MUSt SIGN THIS CERTIFIGATION 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 nay 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." (Signature of Permittee) Permit Date: 11/1/2012-10/31/2017 l , k I - (Date) SWU-248, last revised 10/25/2612 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG120000 Date submitted g1a-1 l ! CERTIFICATE OF COVERAGE NO. NCG12 FACILITY NAME =re�e II �or.+�t+t 5vl�d CJagtE FgLC • COUNTY -f-e.R s f / PERSON COLLECTING SAMPLESo�..o-1 LABORATORY Shdes ",11 t C1—/4t1 Lab Cert. ff `t `" Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 7_,7 1 1 SAMPLE PERIOD ❑ 1an-June K[1uly-Dec or ❑ Monthly` Imonthl DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA RECEIVED ❑Zero -flow ❑Water Supply (:]SA Other SEP 2 5 2017 CENTRAL FILESPLEASE REMEMBERTO SIGN ON THE REVERSE DWR SECTION El No discharge this period?' OutfaII No. Date Sample Collected' (mo/ddlyr) 24-hour rainfall amount, Inches Chemical Oxygen Demand Fecal Coliform Total Suspended Solids Benchmarks ==_� I _ - 120 mg/L 1000 count per 100 mL 100 mg/L or 50 nig/L" S o-S- 6- f'1 . (P'i Gas 390 65•1(67 ;L9 5 3&• 33 S00-5-�- q-�-r't . �� 37 Son Iola 1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. 2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 3The 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. "See General Permit text, Table 3, 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 jL" 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". 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 Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 Part 13: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. No discharge this period?2 Outfall No. Date Sample Collected' (ma/dd/pr) 24-hour rainfall amount, Inches Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =__> - _ - 15 mg/L 100 mg/L or 50 mg/L' 6.0 — 9.0 SU 5Do-11 9-S�—rrl . �? (.4(� Footnotes from Part A also apply to this Part B Note: If you report a sample value in excess of the benchmarlc, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART 6 MONITORING RESULTS: o A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. 0 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART It SECTION B. o TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCE5 FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES 0 NO REGIONAL OFFICE CONTACT NAME: Mail on oriainal and one copy of this DMA. including all "No Discharge" reports, within 30 dovs of receipt of the tab results tor at end of monitorinrrperiod 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 1`41I)ST SIGNV THIS CERTIFICATION FdR AhY Ii;iFf7RWV ftON 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 hest 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." (Signature of Permittee) (Date) Permit Date: li/1/2012-10/31/2017 SWU-248, last revised 10/25/2612 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG120000 Date submitted CERTIFICATE OF COVERAGE NO. NCG12 0 0 4 _Z y // FACILITY NAME =ve.2s if o o(,_ COUNTY _-e-Qelf PERSON COLLECTING SAMPLES LABORATORY'9--tesv-ife i4 Z,,t -I Lab Cert. # SAMPLE COLLECTION YEAR 2-0 1 Z SAMPLE PERIOD E4,lan-June ❑ July -Dec or ❑ Monthly' (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA ❑Zero -flow []Water Supply ❑SA Comments on AA sample collection or analysis: r'�t UEI V ED [Other Ca{ JGc�'"[ct' 4.titr,,.t....1�'rpf� yjfir K {vta�s r k r.t�rous e�a..� F b-;h- fin 50. ► • Z--t -, JUN 12 2017 PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Part A: Stormwater Benchmarks and Monitoring CENTRAL_ FILES Results DWI SECTION} ❑ No discharge this period?' Outfall No. Date Sample Collected) (mo/dd/yr) 24-hour rainfall amount, Inches Chemical Oxygen Demand Fecal Coliform Total Suspended Solids Benchmarks =__> _ - 120 mg/L 1000 count per 100 mL 100 mg/L or 50 mg/L SDo-S-I 1-7 1•Z 3 Saaa A71,) 5015- S- 2-- S j_-t I-1 IZ.5 .G .2S q 9 n D ��. 55ta SDo-s-S S .k 1? 1• 2-5 a.5 53 17 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. 2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 3The 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. "See General Permit text, Table 3, 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 retort 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". 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. Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?z Outfall No. Date Sample Collected' Imo/dd/yrj 24-hour rainfall amount, Inches; Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks ===a _ 15 mg/L 100 mg/L or 50 mg/L4 6.0 — 9.0 SU 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 II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 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 oriainal and one coav of this DMR. includina all "No Discharae" reports, within 30 dovs of receipt of the lab results for at end of monitoring period in the case of "No Discharae" 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. am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) (Date) Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No, NCG120000 Date submitted Ca � 8 ( Zo 1 7 CERTIFICATE OF COVERAGE No. NCG12 0 O '4' 2-- FACILITY NAME L&-e4f-'I COUNTYr,e.4t f l PERSON COLLECTING SAMPLES A LABORATORY'U t ✓Xe_ 2n0.tti+ —I Lab Cert. N Comments on sample collection or analysis: �'o�fGt.. t,F}a..B �-oMsee•—t✓� � g e.s � Y[c.ew�l•.bt't r-� h Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR a' G " 1 SAMPLE PER_ IOb [ Jan-lune Diu] - V-Dec or ❑ Monthly'(month) DISCHARGING TO CLASS ❑ORW ❑HQW [-]Trout ❑PNA ❑Zero -flow ❑Water supply ❑SA RECEIVE n 00ther JUN 12 2017 PLEASE'REMEMBER TO SIGN ON THE REVERSE -� CENTRAL FILES DWR SECTION ❑ No discharge this period?-' Outfall No. pate sample Collected' (mo/ddJyr) 24-hour rainfall amount, Inch -es Chemical Oxygen Demand Fecal Coliform Total Suspended Solids Benchmarks == > - - 120 mgJL 1000 count per 100 mL 100 mg/L or 50 riig/t" 50o- 5-`f 5/�L-57r-I t,5 G a 5 7 Go6a 80. S spa- 5-5 G. �L-5 7 (a000 t l 7-- I Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfali. 2For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 3The 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. a See General Permit text, Table 3, 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". Note: If you report a sample value in excess of the benchmarlr, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. Permit Date: 11/112012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 Part 13: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Non -polar O&G/TPH by 'EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks -__> _ 15 mg/L 100 mg/L or 50 mg/0 6.0 — 9.0 Su 3cY 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: e A BENCHMARK1XCEEDANCE 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. 5EE PERMIT PART-11 SECTION e, TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCE£DENCES 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 on original and one conv of this DMR. includina all "No Discharge" reports. within 30 days of receipt of the lab results (or at end of monitoring 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 sidVTHI5 CERTIFICATION FOR ANY INFt3RMATlON�RE'0ORTED: "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 nest 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." (Signature of Permitteej Permit Date: 11/1/2012-10/31/2017 (�, (e �( -I (Date) SWU-245, last revised 10/25/2612 Page 2 of 2 Semi-annual Stormwate_r Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG120000 Date submitted F•c b qj_ Zo [ 'Z CERTIFICATE OF COVERAGE NO. NCG12 O 0-�~-- FACILITY NAME 3rce(sr( Co...�i'� /.,I , eQ (,k,6_sfe, COUNTY -X c t! PERSON COLLECTING SAMPLES LABORATORY Lab Cert. E# Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2—O f 6 SAMPLE PERIOD ❑ Jan -June July -Dec or ❑ Monthly} (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA []zero -flow []Water Supply [:]SA RECEIVED ELOther FEB 16 2017 PLEASE REMEMBER TO SIGN ON THE REVERSE 4 CENTRAL FILES DWR SECTION .No discharge this period?? Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, inches Chemical Oxygen Demand Fecal Coliform Total Suspended Solids Benchmarks ===> _ 120 mg/L 1000 count per 100 mL 100 mg/L or 50 mg/O 5- ` Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. 2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 3The 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. "See General Permit text, Table 3, 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". !Vote., 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. Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. n No discharge this period?' Outfall Na. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches; Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks ===> _ 15 mg/L 100 mg/L or 50 mg/L 6.0 -- 9.0 SU 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 II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALLTRIGGER 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 ONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an oriainal and one cony of this DMR. including all "No Discharae" reports. within 30 days of recelnt of the lab results (or at end of monitoring period in the case of "No Discharae" reoortsl to: Division of Water Quality Attn: DWQ Central Files IG17 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "1 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." (Signature of Permittee) Permit Date: 11/1/2012-10/31/2017 a- r 7 (Date) SWU-248, last revised 10/25/2012 Page 2 of 2 Semi-annual_Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit NO. NCG120000 Date submitted /;L j ��o f 6 CERTIFICATE OF COVERAGE NO. NCG12 0 0 1 -2-- FACILITYNAME ��etde(I' �k f� Sol'd c,J45fc - - COUNTY -7:,cdef! PERSON COLLECTING SAMPLES LABORATORY Lab Cert. tl Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR Za i 6 SAMPLE PERIOD ❑ Jan -June ❑ July -Dec or gmonthly= (month) DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA []zero -flow ❑Water Supply []SA (,O the r L•s V ccz DEC 0 92016 PLEASE REMEMBER TO SIGN ON THE REVERSE DUVR L �Crl", -discharge No dischar e this period?' Clutfali No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches -'Y Chemical Oxygen Demand Fecal Coliform Total Suspended Solids Benchmarks ===> - - 120 mg/L 1000 count per 100 mL 100 mg/L or 50 mg/L4 sf)o 5-f s 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. 3The 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. See General Permit text, Table 3, 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". 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. Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. [XNo discharge this period?' Outfall No. Date Sample Collected, (mo/dd/yr) 24-hour rainfall amount, Inches3 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =__> _ - 15 mg/L 100 mg/L or 50 mg/O 6.0 — 9.0 SU SDo`1 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 II 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 AT ANY ONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR. includina all "No Discharae" reports. within 30 days of receipt of the lab results for at end of monitorina period in the case of "No Discharae" 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 am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) Permit Date: 11/1/2012-10/31/2017 1 -q (n lt (.— (Date) SWU-248, last revised 10/25/2012 Page 2 of 2 Semi-annual Stormw_ ater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG120000 Date submitted /A— A�-'a01 b CERTIFICATE OF COVERAGE No. NCG12 D, 0 4 a- SAMPLE COLLECTION YEAR aO f fo FACILITY NAME Tg-eG1e r ( Solidi WcLS-(v��.cr(r�,T SAMPLE PERIOD ❑ Jan -June July -Dec COUNTY JSZcAe- f ( or ❑ Monthly' _ _ (month' PERSON COLLECTING SAMPLES DISCHARGING TO CLASS 171ORW ❑HQW []Trout ❑PNA LABORATORYS�eSvilie�v<a(�ts�.(LabCert.iJ 4µ� ECEIVED ❑Zero -flow []Water Supply ❑SA Comments on sample collection or analysis: [Other OLC L 9 1016 Part A: Stormwater Benchmarks and Monitoring Results CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4 DWR SECTION n No discharge this period?2 OuEfaEl No. Date Sample Collected` (mo/dd/yr) 24-hour rainfall amount, inches3 Chemical Oxygen Demand Fecal Conform Total Suspended Solids Benchmarks =__> 120 mg/L 11000 count per 100 mL 100 mg/L or 50 mg/L' ' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. 'For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 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. ' See General Permit text, Table 3, 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, Nan -detect, ND, or other similar non- ntumerical format. When results are below the applicable limits, they mu t be reported in the format "<XX m L", where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliforrn results exceed the dilution upper limit, report the result as ">XX". 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. Permit Date: it/l/2012-10/31/2017 SWU-249, last revised 10/27/2012 Page 1 of 2 Part B-. Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. No discharge this period?' Outfalf No. Date Sample Collected, (mo/dd/yr) 24-hour rainfall amount, Inches' Non -polar O&G/TPH by EPA 1664 (SGT•HEM) Total Suspended Solids pH Benchmarks -==? 15 mg/L 100 mg/L or 50 mg/L4 6.0 — 9.0 SU SDn--► 1;L r73 6,94 Footnotes from Part A also apply to this Part B Mote: if you report a sample volue 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 n. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES 0 NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one coov of this DMR, includinq all "No Discharqe" reports,. within 30 days of recut of the lob results (or at end of monitorina period in the case of "No Dischorae" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1517 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "t certify, under penalty of lavr, 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." (Signature of Permiltee) Permit Datc:11/1/2012-10/31/2017 (Date) SWU-248, last revised 10/25/2012 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG120000 Date submitted � I I, ( it (2 o t k� CERTIFICATE OF COVERAGE NO. NCG12 0 0 _� FACILITY NAME �,L� ��t Go ot cw S COUNTY -�LW C_4e_-tt PERSON COLLECTING SAMPLES LABORATORY Lab Cert. 11 Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR Zo l (- SAMPLE PERIOD ❑ Jan -June ❑ July -Dec or RMonthlyi lrrtonth) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA RELIVED Zero -flow ❑Water Supply USA Other NOV 16 2016 PLEASE REMEMBER TO SIGN ON THE REVERSE 4 CENTRAL FILES DWR SECTION 54'No discharge this period?' Dut#all No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, 3 inches Chemical Oxygen Demand Fecal Coliform Total Suspended Solids Benchmarks ===> i - - 120 mg/L 11000 count per 100 mL 200 mg/L or 50 mg/C S� L+ I Sad-5� l ' monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. -'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. '' See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchnark 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 me/L", where XX is the numerical value of the detection limit, reporting limit, etc, in mg/L. Conversely, ':here fecal Coliform results exceed the dilution upper limit, report the result as ">XX". 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. p,?rillli Date: 11/1/2012-10/31/20!7 Sviu-2,18, last revised lo/25/2012 Page 1of2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per nionth. nNo discharge this period?'' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches'; Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Renchmarks =_=> 15 mg/L 100 mg/L or 50 mg/1-4 G.0 — 9.0 SU Sao-i 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. 0 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART fl SECTION B. e TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES 0 NO REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharqe" reports, within 30 dot's of receipt of the lab results (or at end of monitorina Aeriod 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 lava, 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 ar�,significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) Permit Date: 11/112012-10/31/2017 f[ It (Date) SWU-248, last revised 10/25/2012 Pare 2 of 2 . �•4 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG120000 Date submitted SZ fi SS', z-. f 4 CERTIFICATE OF COVERAGE NO. NCG12-0 0 2-- FACILITY NAME Cg-'Qde I ( Co COUNTY PERSON COLLECTING SAMPLES LABORATORY Lab Cert. h Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2 o t to SAMPLE PERIOD ❑ Jan -June ❑ July -Dec or 0 Monthly' F- month DISCHARGING TO CLASS ❑ORW OHQW ❑Trout ❑PNA ❑Zero -flow [:]WaterSupply ❑SA �,1A gOther RECEIVED BCT 0 5 z916 PLEASE REMEMBER TO SIGN ON THE REVERSE 4 [SNo discharge this period?' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, inches3 DWR SECTION Chemical Oxygen Demand Fecal Coliform Total Suspended Solids Benchmarks ===> - - 120 mg/L 1000 count per 100 mL 100 mg/L or 50 mg/0 5L),) -4 Sr�a-S-I ' 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. 3The 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. " See General Permit text, Table 3, 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". 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. Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. n No discharge this period?' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Non -polar 0&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks 15 mg/L 100 mg/L or 50 mg/L4 6.0 — 9.0 SU 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 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. e 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL T RIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART Il SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 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 copy of this DMR, includina all `No Discharae" reports, within 36 dovs of receipt of the lab results (or at end of monitoring period in the case of "No Discharae" 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 late, 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." (Signature of Permittee) (Date) Permit_[�,ite: 11/1/2012-10/3112017 SWU-248, last revised 10/2S/2012 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG120000 Date submitted 53&Pf- x-`w , z.o r (,c, CERTIFICATE OF COVERAGE NO. NCG12 0 D _q FACILITYNAME :r-cdtrl Ca--t-f Sof;d W45f*- - COUNTY PERSON COLLECTING SAMPLES LABORATORY Lab Cert. # Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results RECEIVED CENTRAL FILES SAMPLE COLLECTION YEAR ,2- 0 1 b ©WR SECTIQN SAMPLE PERIOD ❑ Jan -June ❑ July -Dec or ® Monthly' (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA [_]zero -flow (—]Water Supply ❑SA other PLEASE REMEMBER TO SIGN ON THE REVERSE 4 P.No discharge this period: Out#all No. Date Sample Collected, (mo/dd/yr) 24-hour rainfall amount, Inches; Chemical0 xygen Demand Fetal Co[iform Total Suspended Solids Benchmarks ==_> - - 120 mg/L 1000 count per 100 mL 100 mg/L or 50 mg/L ' 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. 3The 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. Q See General Permit text, Table 3, 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". 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. Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > S5 gal of new oil per month. ❑ No discharge this period?' Outfall No. Date Sample Collected, (mo/dd/yr) 24-hour rainfall amount, IncheS3 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =_-> _ 15 mg/L 100 mg/L or 50 mg/L° 6.0 — 9.0 SU Footnotes from Part A also apply to this Part B !Vote: 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 4 OR MORE BENCHMARK EXC€EDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR. includina all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring Period in the case of "No Discharae" renort5) 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: "1 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." (Signature of Permittee) Permit'D,% e: 11/1/2012-10/31/2017 (Date) SWU-248, last revised 10/25/2012 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG120000 Date submitted P-= f51 La IlP CERTIFICATE OF COVERAGE NO. NCG12 O O CF y FACILITY NAME T-e.le{_t COUNTY -T-4-c le t< PERSON COLLECTING SAMPLES LABORATORY Lab Cert. # Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR Z-- 16 SAMPLE PERIOD ❑ Jan -June ❑ July -Dec or [?.Monthly' �.,t., (month) DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA RECEIVED [_]zero -flow ❑Watersupply []SA AUG ] 9 2016 [Other CENTRAL. FILES 7[� E REMEMBER TO SIGN ON THE REVERSE 4 DWR SECTION No discharge this period?' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches Chemical Oxygen Demand v Fecal Coliform Total Suspended Solids Benchmarks =__> _ - 120 mg/L 1000 count per 100 mL 100 mg/L or 50 mg/L° SO o- 4 Spa- 5 h"r 674 + J�, T off ' 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. 3The 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. ° See General Permit text, Table 3, 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 me/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". 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. Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 Part 8: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. C1 No discharge this period?' Outfall No. Date Sample Collected, (mo/dd/yr) 24-hour rainfall amount, Inche53 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =_=> - 15 mg/L 100 mg/L or SO mg/L° 6.0 — 9.0 SU Footnotes from Part A also apply to this Part B Note: If you report a sample value in excess of the benchmark, you most 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 OUTFALLTRIGGER 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 ANYONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an oriainal and one coov of this DMR. includina all "No Discharae" resorts, within 30 days of receipt of the lab results for at end of monitoring period in the case of "No Discharae" 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: "1 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." (Signature of Permittee) (Date) Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG120000 Date submitted CERTIFICATE OF COVERAGE NO. NCG12 O O (� y FACILITY NAME TW-cde r ( cdasfie Fwc 1111 1 COUNTY PERSON COLLECTING SAMPLES LABORATORY Lab Cert. # Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2-0I b SAMPLE PERIOD ❑ Jan -June ❑ July -Dec or KMonthly' --T-N — (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA []zero -flow ❑Water Supply [_]SA Epther _.dA 7> PLEASE REMEMBER TO SIGN ON THE Nodischarge i eri ?2 g this p od Outfall No. date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches Chemical Oxygen Demand Fecal Coliform Total Suspended Solids Benchmarks 120 mg/L 1000 count per 100 mi. 100 mg/L or 50 mg/L 540 — D V tJ" ' 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. 3The 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. ° See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Nate: 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". 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. Permit Date:11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 it, if ' Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?z Outfall No. Date Sample Collected (mo/dd/yr) 24-hour rainfall amount, IncheS3 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks ===> _ - 15 mg/L 100 mg/L or 50 mg/L° 6.0 — 9.0 SU 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 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 ANYONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one ropy of this DMR. includina all "No Discharae" reports, within 30 days of receipt of the lab results (or at end of monitoring 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." (Signature of Permittee) (Date) Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 2 of 2 r. Semi-annual Stormwa_ter Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG120000 Date submitted tvi vll.2-ID Z-o I [p CERTIFICATE OF COVERAGE NO. NCG12 D 0 4 SAMPLE COLLECTION YEAR fort. FACILITY NAME Uedetl CoLL_ t+} _5of�_d_ Wa_sfvt F_0._SAMPLE PERIOD ❑ Jan -June ❑July -Dec COUNTY =«'e-Pe r( �- or © Monthly' Kl� /mantic) PERSON COLLECTING SAMPLES 1Qo n�f� ���-_"-'�-5_ _ DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA LABORATORY Q. (i r--A Lab Cert. It []Zero -flow ❑Water supply ❑SA Comments on sample collection or analysis: h r. t{(/ her "TSS , 5D6—j5 QJSo % F'RECEI V ED Cu vrc ► PLEASE A13£R TO SIGN ON THE REVERSE 4 MAY 2 5 �tiio Part A: Stormwater Benchmarks and Monitoring Results ,. CENTRAtL, FILES AiischarCgg this period?-' Outfall No. Date Sample Collected' (mo/ddJyr) 24-hour rainfall amount, Indtes3 UVVK zit Chemical Oxygen Demand Fecal Cotiform ToAs;� n d e d 5 o I i d s Benchmarks ===> - - 120 mg/L 11000 count per 100 mL 100 mg/ vrS0 mg/L eDo —r-f 5%3 r t: /. ]-5 I 41 { 7 "l 5 3 444 SDa-S-I 5 i l� �5 I -43 -7 taop 535 I l I ' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. For sampling periods with no discharge at any single outfall,jou must still submit this discharge monitoring report with a checkrnark here. '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. " See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where cite more protective benchmark applies. Note: Results must be reported in numerical format. For example,, do not report fielow Detection Lirnit, BDL, <PQL, Non -detect, ND, or other similar non- nmmerical format. When results are belovv 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". 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. Permit Date: 11/1/2012.10/31/2017 511+1U-248, last Ievised 10/25/2012 Page t of 2 t`z.K B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge (his periods' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches) Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks ===� 15 mg/L 100 mg/L or 50 mg/L' 6.0 — 9.0 SU Footnotes from Part A also apply to this Part B Note: if you report a sample value in excess of the benchmark, you must irnplernent Tier 1, Tier Z, or Tier 3 responses. See General Permit text. FOR PART A AND PART B fvIONITORING RESULTS: ■ A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART lI SECTION B. • 2 EXCEEDANCES IN A R04lr FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART If SECTION B. C TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES 0 NO 0 REGIONAL OFFICE CONTACT NAME: Mail an oriainal and one coon 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 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 cer tify, under penalty of 1a:1, that this document and all attachments vv-01e 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 %nho 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 a,. -fare that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) f v,-rmit Date: 11/t/2012-10/3L/2017 (Date) S%VU-2.13, last revised 10/25/22012 PaGe 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG120000 Date submitted A I2,J `1, -Lo r �- CERTIFICATE OF COVERAGE NO. NCG12 6" 6_ 44' ', - FACILITYNAME T=-eJcrl Co» 14 S.t•� �s+4 COUNTY 2K�a4L tl PERSON COLLECTING SAMPLES LABORATORY Lab Cert. 4 Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR '?'g i b SAMPLE PERIOD ❑ 1an-June ❑ luly-Dec or ® Monthly'_ (_month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA []Zero -flow ❑Water Supply ❑SA Other d o s s C__ luIEFfV t� APR EFn PLEASE REMEMBER TO SIGN ON THE REVERSE CE ZC i Nrs�L F �� R SFr��— 0,No discharge this period? Outfall No. Date Sample Collected' (me/dd/yr) 24-hour rainfall amount, Inches3 Chemical Oxygen Demand Fecal Coliform Total Suspended Solids Benchmarks ===> 120 mg/L 1000 count per 100 mL 100 mg/L or 50 mg/L' Spo-S—t ' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. 2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 3The 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. " See General Permit text, Table 3, 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, "<X?( melL", 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". !Vote: 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. Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?-' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks -_> _ 15 mg/L 100 mg/L or 50 mg/L4 6.0 — 9.0 SU 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 II 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 AT ANY ONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Moil an original and one copV.of this DMR, including all_"No Discharge" reports,_ within 30 do s o receipt a the lab.results (or at end of monitorina aeriod 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 CERTI 1 TION 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." (Signature of Permittee) Permit Date: 11/1/2012-10/31/2017 ( 121 R 12101J6 (Date) SWU-249, last revised 10/25/2012 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG120000 Date submitted (--e b 1 g , Za t co CERTIFICATE OF COVERAGE NO. NCG12 O 0 er 2-- FACILITY NAME so LZA COUNTY PERSON COLLECTING SAMPLES LABORATORY A. .aI chLab Cert. # 44 `+ 0 Comments on sample collection or analysis: 1 GmiI�Glta �4�1�t l��.p1�A �OwrOo 1. ^ - oV�r � K�M 1 "� qe P ►O i� l L. r 1 S +� ... ` #R` S .{ CD Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR Z n k (0 A'MPLE•P IOD ❑ Jan -June ❑ July -Dec 1'or� Aonthlyi i=e-Si month DIF&jF§4GTO PNA Z016 CLASS �ORW ero-flo❑Hw ❑Water Supply❑❑SA DWR-p L F [30ther LLa.55 G DwRCEAJ7 ro� s��r PLEASE REMEMBER TO SIGN ON THE REVERSE ❑ No discharge this period?' Outfall No. Date Sample Collected (mo/dd/yr) 24-hour rainfall amount, Inches; Chemical Oxygen Demand Fecal Coliform Total Suspended Solids Benchmarks -==> - - 120 mg/L -1000 count per 100 mL 100 mg/L or 50 mg/0 5t)o- t112-15 Lr13 -[Sy op-�-t 1 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. 3The 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. "See General Permit text, Table 3, 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 me/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". Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, 77er 2, or Tier 3 responses. See General Permit text. Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period:2 Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Iriches3 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =__> _ - 15 mg/L 100 mg/L or 50 mg/L 6.0 — 9.0 SU IRP 4Sb L31•S CQ-9a. 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, Ter 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 PART11 SECTION B. • 2 EXCEEDANCES IN'A ROW FOR -THE SAME PARAMETER-ATTHESAME.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 ONE OUTFALL? YES ❑ NO ®. IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an oriainal and one coov of this DMR. includina all "No Discharae" reports, within 30 days of receipt of the lab results for at end of monitoring period in the case of "No Discharae" 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. l am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." OWN !�Iwo NO (Signature of Permittee) Permit Date: 11/1/2012-10/31/2017 F.e�b t a a'Lolb {Date) SWU-248, last revised 10/25/2012 Page 2 of 2 r� Semi-annual Stormwater_Discharge Monitoring Report - for North Carolina Division of Water Quality General Permit No. NCG120000 Date submitted l—ll'Z°tLP CERTIFICATE OF COVERAGE NO. NCG12 FACILITY NAME COUNTY - PERSON COLLECTING SAMPLES o e_— LABORATORY 54&4e5mZkke Q t1,1-hab Cert. # 'k ` '0 Comments on sample collection or analysis: '(�e5 ��-F-s � e� e_ ,.s.. 3 ��4Ce� c�.t.d� e► 5 'r�C .,�t� b t t /<•-C.GlI w�4t 1.ti «Y+ S d t v-+ � � r t.a G r- Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR D'Lo V 5 SAMPLE PERIOD ❑ Jan -June [ �uly-Dec or ❑ Monthly' month DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA []Zero -flow ❑Water Supply ❑SA RECEIVED Other G :i--- JAN 14 Z016 CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE DWR SECTION Ej No discharge this period?2 Outfail No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall as Inches Chemical Oxygen Demand Fecal Collform Total Suspended Solids Benchmarks 120 mg/L '1000 count per 100 mL 100 mg/t or 50 mg/L 1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfail. For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 3The 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. See General Permit text, Table 3, 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". 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. Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period:2 Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =__> - - 15 mg/L 100 mg/L or 50 rng/O 6.0 — 9.0 SU SDo�� l0 2Y 15 . �tfl 0 5. cp 'I.0 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 OUTFALLTRIGGER 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 ANYONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an oriainal and one conv of this DMR. includina all "No Discharae" reports, within 30 days of receipt of the lab results for at end of monitorina period in the case of "No Discharae" 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." k-i\-t�p (Signature of Permittee) (Date) Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG120000 Date submitted sA"` -7 , 2-01 b CERTIFICATE OF COVERAGE NO. NCG12 0 0 4 ;;7— FACILITYNAME COUNTY L wit PERSON COLLECTING SAMPLES ^D'� Lrt�-b�=F ►'Lade`' a� �e5 LABORATORY Lab Cert. ft 4f o Comments on sample collection or analysis: a.,dZ �QSie� 7�ao10 r-FU W11 Part A. Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2O t5 SAMPLE PERIOD ❑ Jan -June ® July -Dec or ❑ Monthly' (month) DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA ❑Zero -flow [:]watersupply [:]SA E�40ther G [as5 G PLEASE REMEMBER TO SIGN ON THE REVERSE 4 ❑ No discharge this period?' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches Chemical Oxygen Demand Fecal Coliform Total Suspended Solids Benchmarks ===> - - 120 mg/L 1000 count per 100 mL 100 mg/L or 50 mg/L 5oo [2 67Z of [. Z5 5 CC'goo (C) ( 500-5-[ Zaf5 t,ZS Caoao S D ID— 5 Z: ((j Zo 15 b o 0 ' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. 2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 3The 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. See General Permit text, Table 3, 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, theYmut 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". 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. Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period: Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =_=> - 15 mg/L 100 mg/L or 50 mg/L 6.0 — 9.0 5U 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 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: I + 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 If SECTION B. + TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO [, IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an oriainal and one coav of this OMR. includina all "No Discharae" reports, within 30 days of receipt of the lab results for at end of monitorina aeriod in the case of "No Discharae" 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. am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) Permit Date:11/1/2012-10/31/2017 (— -7- Zot'j (Date) SWU-248, last revised 10/25/2012 Page 2 of 2 TIER 1 RESPONSE Initially placed in operating record per permit recordkeeping requirement on 1/11/2016, Tier One Response due to concentrations of Fecal Coliform (FC) >6000CPU/100m1) detected in sample collected from SDO-5-1 on 12/17/2015. Elevated FC levels as identified in sample SDO-5-1 collected on 12/17/2015 are very likely not attributed to landfill activities rather originating from wild animal waste in and around the SDO-5-1 drainage. In fulfillment of permit requirements this Tier One response was initiated in response to the analytical benchmarks. A sample of raw leachate (water that has percolated through the waste mass) was taken from the leachate lagoon in flow on 12/8/2014, This sample was tested for fecal coliform and was Found to have only a trace, 11 CFU/lOOml. This result offers additional evidence to confirm the source is not originating from the landfill activity but instead comes from wildlife activity. However Iredell County will initiate Tier One response as detailed below. There was also an exceedance in Total Sus ended Solids from the sample collected on the same date. Tier One response t.or this parameter will be initiated as well and is documented below. Identification and Evaivation of Potential Causes of Exceedance On 1/06/2016 area between SDO-5-1 and the landfill was inspected by David Lambert, Teddy Boller and Ronald Browning of Iredell County. Durrn the inspection, possible causes of the exceedances were identified, evaluated and specific physical improvements were considered which may potentially decrease concentrations of the contaminant of concern. The drainage area upstream of SDO-S-i is controlled by an extensive E&5C system previously ap pproved by NCDENR Land Qualityy Section. The E&SC system upstream of Su0-5-1 consists of a ditch line that discharges onto a rock overflow sp i 1 l way, Control led Stormwater discharges across a burred sewer line right of way and into an unmanned tributary, of Fourth Creek. Evidence ofcontaminated Stormwater entering the SDO-5-1 drainage area was not observed. The receiving stream has been monitored at two locations downstream of SDO-S-I semi-annually since prior to Phase 5 construction as part of the water quality monitoring program with no exceedances of 213 surface water Standards. Potential physical improvements under consideration with intended date of implementation are as follows: (activity such as seeding must take place Outside the 2 month deadline for improvement due to weather) Improvement / Maintenance Repair or replace darnaged baffles. Date of implementation Begin use Of flocculent granules and floc brick Date of implementation Signed as required by Permit Section B. 5 (Il) David Lambert Iredell County Solid Waste Director a c.tcQ ..•w. W I J-L� A.-� 1 rate-. TIER II RESPONSE Initially placed in operating record per permit recordkeeping requirement on 12/1 1/2015. Tier Il Response due to concentrations of Fecal Coliform (FC) greater than 6000 CPU1100ml) detected in sample collected from SDO-4 on 12/ 17/2015. Elevated FC levels as identified in sample SDO-4 collected on 12/14/2015 are very likely not attributed to landfill activities rather originating from wild animal waste in and around the SDO-4 drainage. In fulfillment of permit requirements this Tier II response was initiated in response to the analytical benchmarks. A sample of raw leachate (water that has percolated through the waste mass) was taken from the leachate la loon in flow on 12/8/2014. This sample was tested for fecal co iform and was found to have on y a trace 1 1 CFU I OOmI. This result offers additional evidence to confirm the source is not originating prom the landfill activity but instead comes from wildlife activity. Additionally it sample was taken from the basin identified as SDO-7 which receives stormwater from the vehicle maintenance area. While Fecal Coliform testing is not required for this basin and it is located approximately 3/4 mile from any active waste disposal testing was conducted in attempt to further prove wildlife activity is responsible for these exceedances on active working face, not landfillin� activities. SDO-7 test results were over 6000 CFU 100m1 and can only be attributed to wildlife activity. However, Iredell County will initiate Tier Two response as detailed below. Additionally TSS was above standard in the first test period of 2015 with a value of 176mg/L. This test results show TSS has declined to l01 mg/L proving previous improvements are working. Those improvements are listed here. Install TerraTubes or similar devices on rock spillways August 2, 2015 .Begin use of floCCulant August 2, 2015 Install 2 fiber filters between inlet and skimmer August 30, 2015 Plant Cattails at inlet August 30, 2015 Identification and Evaluation of Potential Causes of Exceedance On 01/06/2016 area between SDO-4 and the landfill was inspected by David Lambert, Teddy Boller and Ronald Browning of Iredell County. During the inspection, possible causes of the exceedances were identified, evaluated, and specific physical improvements were considered which may potentially decrease concentrations of Fecal Coliform and Total suspended Solids. The drainage area upstream of SDO-4 is controlled by an extensive E&SC_ system previously, approved by NCDENR Land Quality Section. The E&SC system upstream of 5DO-4 consists of a ditch line and plastic culvert pipe that discharges onto a rock overflow spill way. Controlled Stormwater discharges across a buried sewer line right of way and into an unmanned tributary of Fourth Creek. Evidence of contaminated stormwater entering the SDO-4 drainage area was not observed. The receiving stream has been monitored at two locations downstream of SDO-4 semi- annually since rior to Phase 3 and 4 construction as part of the water quality monitoring program with no exceedances of 2B surface water Standards. A possible cause of issues is the amount of area this basin is draining is so great it exceeds the capacity of the basin to handle it properly. The elevation of the landfill is it tops out also causes water to gain velocity as it drops to basin. Wildlife is assume to be biggest contributing factor for fecal colif6rm as the county has proven it exists in areas completely away from waste disposal -units and that it is not present in leachate discharge. d it Potential physical improvements under consideration with intended date of Improvement/Maintenance Apply PosiShell, a cement based stucco like material to exposed soil on top of and side slope of phase 4 to reduce erosion and sediment loading. Date of implementation Place fabric in bottom of ditch line and install rock check dams to reduce velocity and sediment loading. Date of implementation Install culvert pipe at northwest base of phase 4 to divert portion of storm water run-off to large basin on borrow site. Repair and improve baffles in the borrow site basin Date of implementation Begin use of granular flocculent and floc bricks. Date of implementation Weekly inspection of all storm water control devices and structures by Env. Tech who documents findings, recommends and completes repairs when needed. Date of implementati �,�'-"� 1'(I "(�p Signed as required by Permit Section B 5 (1)) ` David Lambert Iredell County Solid Waste Director Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quali y General Permit No, NCG120000 Date submitted�0 CERTIFICATE OF COVERAGE NO. NCG12 0 0 FACILITYNAME Ti2edct( COUNTY :cZeaet PERSON COLLECTING SAMPLES p ee— EI is LABORATORY etwi(Ie an—f fief Lab Cert. # I-cj 4 Comments on sample collection or analysis: Part A: 5tormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR ;101 S SAMPLE PERIOD ❑ Jan -June July -Dec or ❑ Monthly' (month] ®�j� VI4tA ING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA 1i ` VV ��►► �� ❑Zero -flow ❑Water supply ❑5A JUL 2 S 2015 [00ther_ Class c— -_ CENTRAL FILE-;; PLEASE REMEMBER TO SIGN ON THE REVERSE DWR SECTION ro_`�o No discharge this period?2 outfall No. Date Sample Collected (mo/dd/yr) 24-hour rainfall amount, Inches Chemical Oxygen Demand Fecal Coliform Total -Suspended Solids Benchmarks =__> - - 120 mg/L 1000 count per 100 mL _100 mg/t-or 50 mg/L ' 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. 3The 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. ° See General Permit text, Table 3, 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 me/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". 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 Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. F] No discharge this period?' Outtall No. Date Sample Collectedi (mo/dd/yr) 24-hour rainfall amount, Inches; Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks ==-5 _ 15 mg/L 100 mg/L or 50 mg/L° 6.0 — 9.0 SU Sp rT r 2pt5 ..3o .4(o•RS Footnotes from Part A also apply to this Part B !Vote: 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 Il 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 AT ANYONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail an oriainal and one coav of this DMR. includina all "No Discharae" reports, within 30 days of receipt of the lab results (or at end of monitorina period in the case of "No Discharae" 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. am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." �-=- . -7 (-.L,4 (Signature of Permittee) (Date) Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring -Report for North Carolina division of Water Quality General Permit No. NCG120000 Date submitted CERTIFICATE OF COVERAGE No. NCG12 0 0 4- 2 FACILITYNAME �receff Co��.f� Scrrdl�5�� COUNTY ---C r2ee r l PERSON COLLECTING SAMPLES 15d d � e_ LABORATORY An 0.1 tic . Lab Cert. # z4q o Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR �?C 16 SAMPLE PERIOD Jan -June ❑ July -Dec or ❑ Monthly' month DISCHARGING TO CLASS ❑ORW E]HQW []Trout ❑PNA ❑Zero -flow ❑Water Supply [ISA RECEIVED Mother �IAss c JUL 0 6 2015 PLEASE REMEMBER TO SIGN ON THE REVERSE 4 CENTRAL FILES DWR SECTION El No discharge this period?Z outfall No. Date Sample Collected (mo/dd/yr) 24-hour rainfall amount, Inches 3 Chemical -Oxygen Demand Fecal Conform Total Suspended Solids Benchmarks =__> - - 120 mg/L 1000 count per 100 mL 100 mg/!or 50 mg/L 7 G000 I 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. 3The 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. See General Permit text, Table 3, 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 me/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". Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or filer 3 responses. See General Permit text. Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 "Plod ITV Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. � No discharge this period?z Outfal! No. Date Sample Collected' (mo/dd/yrj 24-hour rainfall amount, Inches3 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =__> -. - 15 mg/L 100 mg/L'or 50 mg/O 6.0 — 9.0 Su — O17 • l 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 AND PART 8 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 REQUIRE MENTS.'SEE PERMIT PART It SECTION B. TIER 3: HAS YOUR FACILITY HAD 4 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 oriainal and one coAv of this DMR, including all "No Discharae" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case o "No Discharge" re orts) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 u �� YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:" "I certify, under penalty of law, that this document and all attachments were prepared under niy 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 �,ignlficant penalties for submitting falseinformation, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) Permit Date:11/1/2012-10/31/2017 (o_ 3a - ZocS (Date) T SWU-248, last revised 10/25/2012 Page 2 of 2 TIER t RESPONSE Initially placed in operating record per permit recordkeeping requirement on 6/30/2015, Tier One Response due to exceedance of Total Suspended Solids detected in sample collected from SDO-4 on 6/09/2015. Iredell County will initiate Tier One response as detailed below. Identification and Evaluation of Potential Causes of Exceedance On 6/30/2015 area between SDO-4 and the landfill was inspected by David Lambert of Iredell County. During the inspection, possible causes of the exceedances were identified, evaluated, and specific physical im rovements were considered which may potentially decrease concentrations of TST The drainage area upstream of SDO-4 is controlled by an extensive E&SC system previously a proved by NCDENR Land Quality Section. The E&SC M system upstream of O-4 consists of a ditch line and plastic culvert ,pipe that discharges onto a rock overflow spill way. Controlled Stormwater discharges across a buried sewer line right of way and into an unmanned tributary of Fourth Creek. Evidence of 'contaminated stormwater entering the SDO-4 drainage area was not observed. The receiving stream has been monitored at two locations downstream of SDO-4 semi-annually since prior to Phase 3 and 4 construction as part of the water quality monitoring program with no exceedances of 2B surface water Standards. Potential physical improvements under consideration with intended date of implementation are as follows: (activity such as seeding must take place outside the 2 month deadline for improvement due to weather) Improvement/Maintenance Install TerraTubes or similar devices on rock spillways Begin use of flocculant Install 2 fiber filters between inlet and skimmer Plant Cattails at inlet Signed as required by Permit Section B 5 (1)) David Lambert Iredell County Solid Waste Director Date of Implementation (no later than) August 2, 2015 August 2, 2015 August 30, 2015 August 30, 2015 TIER II RESPONSE Initially placed in operating record per permit recordkeeping requirement on 6/30/2015. Tier iI Response due to concentrations of Fecal Coliform (FC) greater than 6000 CPU/100ml) detected in sample collected from SDO-4 on 6/06/2015. Elevated FC levels as identified in sample SDO-4 collected on 06/06/2015 are very likely not attributed to landfill activities rather originating from wild animal waste in and around the SDO-4 drainage. In fulfillment of permit requirements this Tier If response was initiated in response to the analytical benchmarks. A sample of raw leachate (water that has percolated through the waste mass) was taken from the leachate lagoon in flow on 12/8/2014. This sample was tested for fecal coliform and was found to have only a trace, 1 I CFU I00m1. This result offers additional evidence to confirm the source is not originating, from the landfill activity but instead comes from wildlife activity. Additionally a sample was taken from the basin identified as SDO-7 which receives stormwater from the vehicle maintenance area. While Fecal Coliform testing is not required for this basin and it is located approximately 3/4 mile from any active waste disposal testing was conducted in attempt to further prove wildlife activity is responsible for these exceedances on active working face, not landfillin , activities. SDO-4 test results were over 6000 CFU I00ml and can only be attributed to wildlife activity. However, Iredell County will initiate Tier One response as detailed below. Identification and Evaluation of Potential Causes of Exceedance On 6/30/2015 area betweenSDO-4 and the landfill was inspected by David Lambert of Iredell County. During the inspection, possible causes of the exceedances were identified, evaluated, and specific physical improvements were considered which may potentially decrease concentrations of Fecal Coliform. The drainage area upstream of SDO-4 is controlled b an extensive E&SC system previously approved by NCDENR Land Quality Section. The E&SYC system upstream of SYDO-4 consists of a ditch line and plastic culvert pipe that discharges onto a rock overflow spill way. Controlled Stormwater discharges across a buried sewer line right of way and into an unmanned tributary of Fourth Creek. Evidence of contaminated stormwater entering the SDO-4 drainage area was not observed. The receiving stream has been monitored at two locations downstream of SDO-4 semi-annually since prior to Phase 3 and 4 construction as part of the water quality monitoring program with no exceedances of 2B surface water Standards. Potential physical improvements under consideration with intended date of Improvement/Maintenance Date of Implementation (no later than) Install TerraTubes or similar devices on rock spillways August 2, 2015 Begin use of tlocculant August 2, 2015 Install 2 fiber filters between inlet and skimmer August 30, 2015 Plant Cattails at inlet August 30, 2015 Signed as required by Permit Section B 5 (1)) David Lambert Iredell County Solid Waste Director 34) Licansa No. C-0281 CIVILI SANITARY /ENVIRONMENTAL ENGINEERS munfldpag Services SITE PLANNINGISUBDIVISIONS Nlr. Zahid Khan Stormwater Permitting Regional Engineer 610 East Center Avenue Mooresville, NC 29155 SOLID WASTE MANAGEMENT -..,.,- Company, P.A. SUBSLp0rErJrf /i — ING (SUE) JAN 0 W&Ifiber 30, 2014 CENTRAL FILES DNIR SECTION Re: Stormlvater NPDFS Permit Alternative Source Demonstration for Fecal Coliform a! SDO-4 Iredell County Landfill Permit No. NCG120042 Permit Period Benchmark Exceeded: Year 2 Period I Dear Mr. Khan: The analytical results of a stormwater sample collected from SDO-4 on November 26, 2014 indicated fecal coliform (FC) concentrations at (>2,900 colonies per 100 ml) which exceeds the benchmark outlined in NCG 120000 (1,000 colonies per 100 ml) (see attachment). The benchmark exceedance at this specific outfall is likely not attributed to landfill activities but rather originating from wildlife excrement that has been consistently observed between the outfall and the landfill. Fresh raw/untreated leachate samples collected from the landfill leachate collection system at the lagoon (LAGOON) has never exceeded the benchmark. Levels of FC in the LAGOON samples in colonies per 100 ml were (<I on February 26, 2013 and l 1 on December 18, 2014) which are much lower than detected in sample SDO-4 (2,900 on November 26, 2014) which indicates leachate is likely not a significant enough source of FC to contribute to the levels identified in sample SDO-4. Concentrations of FC in raw leachate samples at other lined facilities has also been consistently lower in relation to stormwater outfall samples and the benchmark. I A full 'Fier One response for this FC exceedance at SDO-4 can/will not be prepared at this time since the source of FC as identified in SDO-4 is likely not attributed to landfill activities and controls/improvements to mitigate FC levels at a landfill are realistically impractical. The facility plans to continue following permit conditions including semi-annual analytical/qualitative monitoring. In the future raw leachate samples may also be tested for stormwater sample comparison purposes. If the NCDENR does not accept this alternative source demonstration in lieu of a "Pier One response please provide us a list of acceptable FC control measures or case studies which have been proven effective in a landfill setting. If you have any questions or concerns regarding this project please contact me by phone at (919) 772-5393 or by email at jpfohl a mesco.com. Sincerely, MUNICIPAL ENGINEERING SERVICES CO., P.A. V-.J--gi,u Jonathan Pfohl Environmental Specialist cc: David Lambert Iredell County DWQ Central Files (Raleigh) Attachments PO Box 97, Garner, North Carolina 27529 (919) 772-5393 PO Box 349, Boone, NC 28607 (828) 262-1,767 r Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG120000 CERTIFICATE OF COVERAGE NO. NCG12 0042 FACILITY NAME lredell Co. Landfill COUNTY lredell Date submitted PERSON COLLECTING SAMPLES David Lambert LABORATORY Statesville Analytical Lab Cert. # 440 SAMPLE COLLECTION YEAR 2014 SAMPLE PERIOD ❑X Jan -June ❑ July -Dec or ❑ Monthly) (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA ❑Zero -flow [:)watersupply [—]SA Comments on sample collection or analysis: QOther Class C Exceedance of FC in SDO-4 is NOT evidence of leachate release as FC levels much lower in raw leachate sample. PLEASE REMEMBER TO SIGN ON THE REVERSE Part A: Stormwater Benchmarks and Monitoring Results {RAW LEACHATE ❑ No discharge this period ?2 Outfall No. Date Sample Collected (mo/dd/yr) 24-hour rainfall amount, 3 Inches Chemical Oxygen Demand Fecal Coliform Total Suspended Solids Benchmarks - - 120 mg/L 1000 count per 100 mL 100 mg/L or 50 mg/L° SDO-4 11/26/14 1.3 <25 m /L 2,900 92 Lagoon 12 18 14 11 1 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. 3The 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 3, 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". 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. Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ri No discharge this period: Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =__> _ - 15 mg/L 100 mg/L or 50 mg/L4 6.0 — 9.0 SU 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. Provided an attached alternative source demonstration in lieu of a Tier One Response for an exceedance of FC at SDO-7.FC levels in raw leachate too low to trigger observed level in SDO-7 and wildlife excrement located between landfill and SDO-7. 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 ATTHE 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 ANYONE OUTFALL? YES ❑ NO 0 IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one coon of this DMR. includina all "No Discharae" reports, within 30 days of receipt of the lab results (or at end of monitorina Period in the case of "No Discharae" 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." (Signature of Permittee) (Date) Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 2 of 2 67 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No, NCG120000 Date submitted �- 3 Lo I5k "T CERTIFICATE OF COVERAGE NO. NCG12 6 '9 I P— FACILITY NAME 1--eeteff COUNTY .rred e PERSON COLLECTING SAMPLES Ok,+ 0 o L a .' ber +- LABORATORYandfyrrc..l Lab Cert. Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR ZO I SAMPLE PERIOD ❑ Jan -June ® July -Dec or ❑ Monthly' (monthl DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA []zero -flow ❑Water Supply ❑SA Mother a G PLEASE REMEMBER TO SIGN ON THE REVERSE 4 ❑ No discharge this period?2 Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches Chemical.Oxygen Demand Fecal Coliform Total Suspended Solids Benchmarks =__> _ - '120 mg/L 1000 count per 100 ml. 100 mg/L or SO mg/L4 0 14 NTRAL L)WQ180G 1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. 2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 3The 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 3, 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 me/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". 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. Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, 3 Inches Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =_=> - 15 mg/L '100 mg/L or 50 mg/L° 6.0 — 9.0 SU 5D6—r7 8—rr—I'{- _�R/Lf rkr-t. 3 (o.If< 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 II SECTION B. 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER ATTHE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART it SECTION B. TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an orioinal and one coov of this DMR, including all "No Discharge" reports, within 30 dovs of receipt of the lab results tar 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 an) aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) Permit Date: 11/1/2012-10/31/2017 2- (Date) SWU-248, last revised 10/25/2012 Page 2 of 2