NCG080201_DMR_20210715

Semi-annual Stormwater Discharge Monitoring; Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCGO80000
Date submitted
CERTIFICATE OF COVERAGE NO. NCGO8 o a o t SAMPLE COLLECTION YEAR coat
FACILITY NAME Ay6 Rw.SPoR: ca,n, T SAMPLE PERIODEJan-June ❑July -Dec
COUNTY_ F�asv� `` r or Monthly' (month)
PERSON COLLECTING SAMPLES ( .wwuv �t RECEI V LD(5HARGINGTOCLASS ❑ORW ❑HQW [—]Trout❑PNA
LABORATORY t_ Lab Cert. # 1ln ❑Zero -flow ❑Water Supply [:]SA
Comments on sample collection or analysis: JUL 2 6 2021 ❑other
vys,et ci jg, } rA DUA4a AoRtk� CENTRAL FILES
DWR SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? ® yes ® no (if yes• complete Part A)
Part A: Vehicle & Equipment Maintenance Areas Monitoring Requirements (If applicable) [ No discharge this period2
Outfall No.
Date Sample Collected'
(mo/dd/yr)
24-hour rainfall amount,
Inches'
Non -Polar Oil & Grease
mg/L
Total Suspended Solids,
mg/L
New Motor or Hydraulic Oil Usage,
gal/mon
Benchmarks
-
1s
100 or 504
Parameter Code
46529
Oo552
C0530
NCOIL
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
"See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018
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a -
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) ❑ No discharge this period2
Outfall :
.. • :� No r:
Date Sample •
C�Ilected',
mo/dd r
/Y }
E 24-hour rainfall
amount,
(riches
-Sample Collected'
mo/dd/yr
Total Suspended .
. Solids, .
m g/
pH,
5tandard•units
Non-Polar.0il &
Grease,
mg/L
100 or 50
:.6.0 = 9.0
t
tip
=
x 46529
-
. C0530 ,.
_ 00400 - ` '
z
00552' s
Footnotes from Part A also apply to this Part B
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 A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitorinc
j,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, or
those persons directly responsible 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 are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Sign ature(of`Permittee
oz zozl
Date
Permit Date: 11/1/2018-5/31/2021
SWU-248, last revised 11/1/2018
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