NCG080583_2020 DMR_20210119 (13)

NCDEQ Di%
Stormwater Discha
on of Energy, Mineral and Land Resources
i Monitoring Report (DMR) Form for N
Transit and Transportation
Click here for instructions
Complete, sign, scan and submit the DMR vi 3 the Stormwater NPDES Permit Data Monitorir
30 days of receiving sampling results. Mail tie original, signed hard copy of the DMR to the
Certificate of Coverage No. NCGO810151 S ;
Facility Name: s c 1,ric: cier lv�tb� a
Facility County:
Discharge during this period: ❑ Yes No
Has your facility implemented mandatory Tier
If so, which Tier (I, II, or III)? - 11%
Part A: Vehicle & Equipment Maintenance Ar
Person Collecting Samples: `; ck Lar-t.
y c
try t�s I Laboratory Name: PG,e. Avw tY- c&
Laboratory Cert. No.: 372U G
r, skip to signature and date)
3onse actions for any benchmark exceedances? KYes ❑ No
I
— Benchmarks in (Red)
within
Parameter
Code
parameter
Outfall
Outfall
Outfall
Outfall ;...
qutfall.,
N/A
Receivin
' Stream Class
_
N/A
Date Sa
ple Collected MM/DD/YY
46529
24-Hour
Rainfall in inches
00552
Non-POIJr
oil & Grease in mg/L (15
.
C0530
TSS in mg/L
(100 or 50*)
00400
pH in standard
units (6.0-9.0)
_
NCOIL
New Motor/Hydraulic Oil Usage in
gal/month
_
Part B: Oil/Water Separators & Secondary Cor
taInment Areas at BUIK Stations a I erminals — oe
cnmarKs In (Kea)
Parameter
Parameter
Outfall
Outfall
Outfall
Outfelh ..
-Outfall:
Code
I
N/A
Receiving Stream Class
N/A
Date Sample Collected MM/DD
46529
24-Hour Rainfall in inches
00552
Non -Polar Oil & Grease in mg/L (15
j
C0530
TSS in m /L (100 or 50*)
00400
pH ins6ndardunits (6.0-9.0)
i
Quality Waters (HQW), Trout Waters (Tr) and Prim: ry Nursery Areas (PNA)
* Outfalls to Outstanding Resource Waters (ORW)High
have a benchmark i .SS limit of 50 mg/L All otherwater
classifications have a benchmark of 100 mg/L. I
Notes (optional): t. o o
f T
I
"I certify by my signature below, under penalty
I
of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system desigr
ed to assure that qualified personnel properly gather and evaluate the information
submitted. Based on r y inquiry of the person or
persons who manage the system, or those persaps directly responsible for
gathering the informal ion, the information sub
itted is, to the best of my knowledge and belief, rue, accurate, and complete. I am
tmitting
aware that there are significant penalties for sL
false information, including the possibilit of fines and imprisonment for
knowing violations."
ignature of P ittee or Delegated Authoriz
Individual Date