NCG030596_DMR_20200325

Appendix F
MAR 3 0 2020
CENTRAL FILE�
DWWR SECTION
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Datesubmitted a/2&Zo
CERTIFICATE OF COVERAGE NO. NCG03 V 5 9 t0
FACtLITYNAME AS
COUNTY
PERSON COLLECTING SAMPLES
LABORATORY F'Cd UbS Lab Cert. # 70
Comments on sample collection or analysis:
Part A. Stomttivater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR X)ao
SAMPLE PERIOD ❑Jan -lone luty-Dec
or 2TMontZ e.hAXt� r*antb!
DISCHARGING TO CLASS E]ORW F]HQW []Trout F -IPNA
❑Zero -flow Water Supply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 -i
(-1 No dischorce this period?''
Outfall No.
Date Sample
Colkctrd'
mo/dd% l
24-hour rainfall
amount,
Inches'
Total Suspended 5olids
pH,
pH,
Standard units
Copper
Lead
Zinc
O&Gr`
Total Petroleum
Hydrocarbons
Total Toxic
Organics'
Bertchrrwrhs ==>
_
-
100 mgf L or 50 r w L'
6-0-9-0
0.007 mg/L
0.03 mg/L
0.067 mgJL
15 mg%L
1 mg/L
4
Ig
6qb
.oci5
.002
.35$
<5r5
—
Monthly sampling (Instead of semi, -annual; must begin with the second Consecutnre benchmark exceedance for the same parameter at the same outfalI.
' For sampling periods with no discharge at any single outfal 1, 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 maybe eligible for a waiver of the ram gauge requirement
' See General Permit, Table 3 Identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
'Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Taal Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
marurfacture use the definition as found in 40 CFR 469.12; for electronic crrstaf manufacture use the definition as found it 40 CFR 469.22; and for cathode ray
tube manufactwe use the definition found in 40 CFR 469,31).
Permit Date: 1111,12012-10/3112017 SWU-245, last revised 10/25/2012
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Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for ? TO monitoring
may be waived_ The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Perms. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement
'Based upon my inquiry of the per -or o, person: directly rezponr.•b a for franagirg compliance with the permit monitoring require inert for total toxic organic
(TTOj l certify that to the best of my knowledge and belief, ro dump ng of concentrated toxic organic into the stormwater or areas v%,iich are exposed to rainfall or
stormwater runoff has occurred since filing the !ast discharge rnoraton ng repot. I further ee•tify that this fatality is implerreert n 5 tare 2€1 the provisions of the
solvent management plan included in the 5tormwater Pollution Prevert o+ P ar '
%mL\ �pj�4
r,ame ;Prirt nzi ei
GKS/(_�A -OAPA aAWIL
Title IPrint title)
3-�s aaQd
15f,ratu-et G ate a
Note Results must be reported in numerical format, Do not report Below Detection Limit, BK <PQL, Non -detect, ND, or other similar non -numerical
format. .vhen results are below the applicable limns, they must be reported in the format, '4(X nte/L", where xx is the numerical value of the detection
limit, reporting limit, etc. in mg•'L.
None." tf 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.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > SS gal of new oil per month.
(- %Ic drscl~orae thisperiodr
Ou fall No.
Date Sample
Collected'
mo/dd/
24-hour ra nfeR
amount,
Inches'
rion-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
" :nee Gene : Pe-mit text, Table 5, ioer lfy.ng re etaec.a v sensitive receivinb water ctas rrcatiorz where the more protective Denchmark applies.
Pe -ma Gate: liri/20124Q51/2017 SWU-245, last revised 10/25/2012
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Note: tf 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 NACINITORING RESULTS:
• A BENCHMARK FXCEEDANCE 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 PERNtIT PART It SECTION B.
• TIER 3: HAS YOUR FACILITY HAD A OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARWETER AT ANYONE OUTFALL? YES Q NO
IF YES, HAVE YOU CONTACTED THE EAVQ REGIONALOFFICE? YES gNO
REGIONAL OFHCE CONTACT NAME: Mr, ift $QVid Khan
Mail an original and one cony of this 1M48 including all "No Discharge reports_ within 30d= Qf receigtaf the tab results (or at end of monitoring period
in the case of "No Discharge" reports) to:
D •,;s on of Water Quality
Attr: DYVQCentra Ves
161? Mal Service Center
Ra e!gh, North Carolina 27699-1617
YOU MKT S -N THIS CIFIRTIFICATION FOR NY INtO t teTJON R PCRT D:
'1 certify, under penalty of law. that this document and all attachments were prepared under my direction or super Sion in accordance with a :.terr designed to
assure that qualified wsonnc Properly gather and ev.luate the information submitted. Based or my inquiry of the pe .on or pe: sms who marage the system, or
those persons directly re.-ponsible'w gathering the reformation, the information submitted is, to the best of any knowledge and belie, true, accurte. and complete.
am aware that there are agni5ort oerakies for submitting false information, including the passibility of f,e: and imprisonment for knowing viola:ior:,-
; z 4�
7ignature of Permittee) iDntel
Permit Date 11,E1.t2012-10,131/2017 SWU-245, last revised 10/2512012
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