NCG140117_COMPLETE FILE - HISTORICAL_20141212

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
IV C& (VD111
DOC TYPE
,�HISTORICALFILE
❑ MONITORING REPORTS
DOC DATE
❑ a ni y 1c) i a
YYYYMMDD

•-STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COV RAGE NO. NCG14 0 1 _1 -1
FACILITY NAME: L- /�ne„/& f l,L"Zf
PERSON COLLECTING SAMPLES f JL ✓Pi
CERTIFIED LABORATORY VValt 1,7,A e Lab #22
Ins Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: o[ (J
SAMPLING PERI D: M July -December ❑ January -June
COUNTY VC?
PHONE NO. ( y JI33- 05,7 S
ADD TO LISTSERVE? ❑YES ❑NO EMAIL: "
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA Trout ❑Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW);
pH
(Standard
Units)
TSS
(mg/L)
Event �
Duration
(minutes)
Total
a
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
z
2 Sampling
-
I 6-9
100 '
-
-
I
I�
}
1 -a-�
7. va
3,
o
�.�,�
�✓
/v
RE
�
I -
tf "NO FL GW4 or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above
If a value is in excess of the benchmar.., or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General P�; rnr. i ier 2
lv5onthly sampling shalt be done until ; consecutive samples are below the benchmark or within the benchmark range. n
TSS benchmark values are 100 mg/I, e•cept v:hen discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l r
„r eiC",, sampled 1111caSur3ile Sto;;", :h•} total pi ccipization r-lust be recorder! using data from an on -site fair; bause.
ED
414
ILES
ION
P,--rrnii i at -: 7/i/7011 ii0/30/7.015 last Revised 71'1 3/ i I

Part B. Maintenance Activity Monitoring Requirements for facilities using > 5:, dal of new motor oil/month -- averaged over a calendar year.
Outfall
No.
Date Sample
Collected
{mo/ected'
pH
(Standard
Units)
TPH using method
I664A 5GT-HEM
(mg/L)
Total suspended
Solids
{mg/L)
Event
Duration
{minutes)
Total
Rainfall,
(in)
New Motor Oil
Usage
j (gal/month)
jl
In Tier Z
Monthly
Monitoring'
{y/n} g,
$1 of Months
in Tier 2
Sampling'
6-9
15
100 '
I
I
/ V
j
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO [g
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
[,.fail Original and one copy of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample for at end of monitoring period
in case of "No Flow") 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
I
hose persons directly responsible for gathering the information, the information submitted is, to the best of my Knowledge and belief, true, accurate, and cornpi t
ann c:: ;what there are ftnificant penalties for submitting false information, including the possibility of fines and imprisonment for know, ing violations."
(Signatur�/bf Permittee)
Ld— w —�
(Date)
/20i?-60130/20i5
�a lu

MRTERiTECH Li�95.lnC.
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Loven -Pineola COLLECTION DATE: 11/23/2014
PERMIT #: COLLECTION TIME: 15:10
ADDRESS: Loven Ready Mix RECEIVED DATE: 11/24/2014
P.O. Box 155 RECEIVED TIME: 15:35
Pineola, NC 28662
REPORTED: 12/3/2014
ANALYSIS
ANALYSIS RESULTS UNITS DATE ANALYST
TSS 3.4 mglL 11/25/14 jrg
LOG 1D: 1411-371 REPORTED BY: NC CERTIFIED LA13 # 50
Tony Gragg, Lab Supervisor

•
STORMWA-TER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERI+AGE NO. NCG141) _l 7 f
FACILITY NAME: ji U r10A I-Ar:.pylk. v. — -Pir0j) lw �igVt
PERSON COLLECTING SAMPLES - -- bt�t __kzy�
CERTIFIED LABORATORY 1,1e- Lab #i
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoriniz Requirements
SAMPLE COLLECTION YEAR: _ cm 14
SAMPLING PERIOD: ❑ July -December January -June
COUNTY VtIM _
PHONE NO. ( AW )
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA VTrout ❑Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)t
PH
(Standard
units)
TSS
(mg/L)
Event
Duration
(minutes)
Total
Rainfall°
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in2Tier
2 Sampling
6-9`
100 '
-
101
,v
I; •'f`O FLOW" or ",NO G#SCN�RuE, Enter "NO FLOW" or "NO DISCHARGE" for each Please make sure to mark the sample oeriod a`�ove.
!1 a value is in e,Coss of the [)enCn)m3; :, or outsice, the benchmark range (.or pH), you !' UI,l '.'nph: relent the Tier 1 or Tier 2 re5oonse5 m t�te Cjetlr-ral Perier 2
i.SCr;tllly yarns i,ng ;gall ,.e iere "w'd ceruecutivt?-,:mples are t)elov4 ;} e t7.'.nC't,fr:,. t 4 .:, ,,,,. ih.i 5enchmark range.
55 i)l. vehrl..j.. .�a. crr- iL''�..'ai :i,=...CCf%t .:il�n C.iSrh;;;Fin5 i0 OP�1;1, �C,`:d, - iUl, :G idi „;31­.:here 'hey are 50:ng;!-
:C ,.,,;r;Or.., I.',0 iO:al ,:recipior. I'I; . !;'rPCor['- a,. -,il �„it,. �O^t iin 011_`�te rain;;augQ.

•
Par. n. 1 ah•. -.• Mainten3110r Activitv Nlonitonnf' Requirements for facilities usine > 5:. -al of ne%v motor oil/month - averaeed over a calendar vear.
Outfall
No.
Date Sample
Collected t
(mo/dd/yr)
pH
(Standard
I Units)
I TPH using method
1664A SGT-HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
Rainfall°
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2 # of Months
y
Monthl ; in Tier 2
Monitoring? i Sampling? i
(y/n)
6-9
15
E
I
v
4
{
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of;eceipt of sample (or at end of monitoring period
in case of "No Flow") 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 v:ho manage the system, or
those l)ersans directly responsible for gathering the information, the information submitted is, to the best of my knowledge and Belief, true, accurate, and complyte
that V"er are significant penalties for submitting false information, including the possibility of fines and imprisonment for kno%.,ing violations."
-,Z7-/ 4/
(SiEn;ji re of Permiitee) (Date)

URTERiTECH LRES.Inc,
- -
POST OFFICE BOX 1056 • k5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: R.H. Loven -Pineola Plt COLLECTION DATE:
5/12/2014
PERMIT ##: COLLECTION TIME:
17:40
ADDRESS: R.H. Loven Company RECEIVED DATE.
5/13/2014
P.O. Box 155
RECEIVED TIME:
10:43
Pineola, NC 28662
REPORTED:
5/21 /2014
� - -- - -------- ------ ----- - -� ANAL YSI S - --
ANALYSIS RESULTS UNITS DATE ANALYST i
TSS
4.5 mg1L 5114I14
L
E
-�-------- III
�I
LOG ID: 1405-183 REPORTED BY: IBC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor