NCG080715_DMR_20210630

Serrli-a rivaa Stoo°rrr ywater Discharge IMorrli toft_ 09ac tt
for North CaroHna DWIsion of Water Qua fty Genelrai PerUinit No. HCGos®®®®
Date submitted 4� - 3v • -) oL 1
CERTIFICATE OF COVERAGE NO. NCG d -7
FACILITY NAME /L Pt��
COUNTY
PERSON COLLECTING S MPLES
LABORATORY U � ab e� A✓ ✓r
Comments on sample collection or analysis:
Part A: Vehicle Maintenance Areas Monitoring Requirements
SAMPLE COLLECTIO AR 1201Z I
SAMPLE PERIOD Jan -June ❑ July -Dec
or ❑ Monthly)_ (month)
DISCHARGING TO CLASS ❑ORW ❑HQW [-]Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
Y) ('��/tz ❑Other
Aft �OPLEASE REMEMBER TO SIGN ON THE REVERSE
❑ No discharge this period'
Outfall
No.
Benchmark
Date
Sample Collected,
mo/dd/yr
00530
00400
v OO556
Total Suspended
Solids, mg/L
SO or 100 s ermit
pH,
Standard units
Within 6. - 9.0
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
15
New Motor Oil Usage,
Annual average gal/ma
�2u oG,�
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes no
(if yes, report your analytical results in the table immediately below)
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals
Outfall Date
No. Sample Collected,
Permit Limit
00556
Non -Polar Oil and Greasy
1664 (SGT-HEI)
15
00530
EPA Method Total Suspended Solids,
50 or 100 see
00400
PH,
Standard units
6.0 - 9.0
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250
last revised O 'ler 25, 2012

STORM EVENT CHARACTERISTICS:
Date _ (first event sampled)
Total Event Precipitation (inches): _
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
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:
0 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 II SECTION B.
0 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 '4Vo Discharge" reports within 30 days of receipt of the lab results for 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, orthose persons
directly re nsi 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 a significant enalties�for submitting false information, including the possibility of fines and imprisonment for knowing violations."
6=3�-a i
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wo/ws/su/npdessw#tab-4
SWU-250 last revised October 25, 2012

f_
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: bttl2://port;il.ncdenr.org/web/wQ/ws/su/npdessw#tab-4
Permit No.: nxi/.
Facility Name:
County: �4'246 <
Inspector: - jo
Date of Inspection:
Time of Inspection: _
Total Event Precipitation (inches):
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
❑ Yes Ql 1-�
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event" However,
some permits do not have this requirement Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event' is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this si#lfature, 1 teryTy/that_04 report isaccurate and complete to the best of my knowledge:
Designee)
SWU-242, Last modified 10/25/2012
Pagel of 2

1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.)
Receiving Stream: 1"0 ii s C- w
Describe the industrial activities that occur within the outfall drainage at
2. Color: Describe the color of the discharge using
Qight, medium, dark) as descriptors:
3. Odor: Describe any distinct odors that the
weak chlorine odor, etc.):
colors (red,prpwn, blue, etc.) and tint
arge may have (i�m� strongly of oil,
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
y1kU
�7tSC 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
2 3 4 5
7. Is there any foam in the stormwater discharge? Yes Lo�-
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes 0
10. Other Obvious Indicators of Stormwater Pollution:
N`
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012