NCG140135_MONITORING INFO_20190919

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V
DOC TYPE
❑HISTORICAL FILE
'MONITORING REPORTS
DOC DATE
p � b � �1 f
YYYYMMDD

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14
FACILITY NAME: m
PERSON COLLECTING SAN1LES% �DIR ,-
CERTIFIEDLABORATORYe+,v,,i~A (iP?' ! Lab tf ry
Lab #
OPTIONALINFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 091
SAMPLING PERIOD: July -December ❑ January -June
COUNTY
PHONE NO. (/d
ADD TO LISTSERVE? YES ONO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA []Trout ❑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)
li of Months in Tier
2 Samplingz
-
-
6-9
100 ,3
-
-
-
2
CE
R
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the Sample period above.
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
!Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I,
For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date:7/1/2011-60/30/2015
:Lz-jVED
19.
AL FILES
Last Revised 7/13/11
Page 1 of 2

•
S

•
Part 8: vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outfall
No.
Date Sample
Collected
Imo/dd/yr)j
PH
[Standard
Units)
TPH using method
1664.4 5G7-HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
a
Rainfall
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
i
# of Months
in Tier Z
Sampling "
6-9
is
100
-
-
Mote —
I
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 coov of this DMR (includine all "No Flow" & "No Discharee" reports) within 30 days of receipt of sample for at end of monitorine 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
those persons 4he
responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aw t significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of P rmittee) (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2

11
STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF CO RAGE NO. NG14y / 3 5
FACILITY NAME: �.-,•,,-
PERSON COLLECTING SAM LES ,6 :l7 �uX%
CERTIFIED LAB0RAT0RYA5W/"A4X4 r ! Lab # /D
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: -20 /y
SAMPLING PERIODS July -December January -June
COUNTY oN3Ir
PHONE N0. (V�
ADD TO LISTSERVP ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout
[]Other
Outfall No.
- -
Date Sample
Collected pH
{Standard
(mo/dd/yr OR
NO FLOW)t Units]
7S5
(mg/L)
Event
Duration
(minutes]
in Tier 2
Total
a Monthly p of Months in Tier
Rainfall Z
Monitoring? 2 Sampling
fin) (y/n)
6-9
1002,3
-
1A10
/-1i�—h.
IN
_
n NE
MAR 2 1 ; 014
nwrIlBOG
r 1� "NO FLOr V" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
2 li a value s in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 orTier 2 responses in the General Permit. Tier 2
monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 T �S benctmark values are 100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are SD mg/I.
•ar each sarnpled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Pagel of 2

Part R: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor ail/month — averaged over a calendar year.
Outfall
Date Sample
Collected
pH
(Standard
Units)
TPH using method
1664A SGT HEM
(mgJl)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total
Rainfall,
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?(mo/dd/yr)1
(Y/n}
# of MI
in TiNo.
Samp
6-9
l5
loo '
Up
I
I----
J--
HAS tiOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES [:]NO[]
HAVE YOU CONTACTED THE REGION? YES ❑ NO'❑
REG10NAL OFFICE CONTACT NAME:
Mail Original and one coov of this DMR (including all "No Flow" &_"No Discharge" reports within_ 30 des of receipt of sample Jorat end of monitorin enod
in ca,e of "No Flow") to:
Division of Water Quality
Attn: DWQCe:ntral Files
1617 Mail Service Center
Raleif,h, North Carolina 27699-1617
YOU MUST S16N TH15 CERTIFICATION FOR ANY INFORMATION REPORTfo:
"i certify, under penalty of law, that this document and all attachments were prepared under my direction ur 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 pers n:,A.,t'tlrl)s'
onsible for gathering the inFoLfmation, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am ;iwar igni€icant penalties for submitting false information, including the possibility of finesaand imprisonment for knowing violations."
(Signa re of (Date)
Perrn t Date: 7/I/2011-50/3D/2015 Last Revised 7/13/11
Page 2 of 2