NCG210086_DMR_20201201

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina DEMLR General Permit No. NCG210000
Datesubmitted IZ—I'Z(�7r7
CERTIFICATE OF COVERAGE NO. NCG210 0 $ SAMPLE COLLECTION YEAR ZO ZU
FACILITY NA�M/E Lo-yCf{— PtiGl�agZ RI=CITI"rSAJ�QPLE PERIOD ❑Jan -June July -Dec
COUNTY /V E ( `(ft1Jv� VV ����JJ or ❑ Monthly' (month)
PERSON COLLECTING SAMPLES 4-�vvl�d CelJtij�i DEC 1 4 ZpAIscHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY Ev�vyouu142Klt,l (,ut6w,Z, LabCert.# ❑Zero -flow ❑Water Supply [:]SA
Comments on sample collection or analysis: CENTRAL FILES ❑OtherDWR SECTION
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results (Monitoring is required only if the facility stores exposed accumulations of sawdust, wood chips,
bark, mulch, or other similar material on site for longer than seven (7) days.)
No discharge this period?z
Outfall No.
Date Sample
Collected
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Chemical Oxygen Demand
Total Suspended Solids
Benchmarks
120 mg/L
100 mg/L or 50 mg/L°
1, Zo'zo
I L
- Vt L
S y L
Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z 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 3, 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 ma/L", where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier responses. See General Permit text.
Permit Date: 8/1/2013-7/31/2018 SWU-245, last revised 7/31/2013
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?z
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks
15 mg/L
100 mg/L or 50 mg/O
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 II 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 and one copy of this DMR, including all "No Discharae" reports, within 30 days of receipt of the lab results (or at end of monitorina Period
in the case of "No Discharae" reDorts) 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."
(Signature of Permittee)
Permit Date: 8/1/2013-7/31/2018
1 Z - -z uzo
(Date)
SWU-245, last revised 7/31/2013
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR) / SPPP Annual Update DATA REVIEW FORM
Calendar Year Zv Zv
Individual NPDES Permit No. NCS
Certificate of Coverage (COC) No. NCG
or
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP.
Facility Name:
County: _/I/ZW L-(-uVvyt°,r
Phone Number: ( 10 ) Total no. of SDOs monitored
Outfall No. _I
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No $i
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No K1
DEC 14 2020
CENTRAL FILES
DWR SECTION
Parameter, (units)
Total
Rainfall,
inches
L Uo
SC
Benchmark
N/A
t Uv \& IL
Date Sample
Collected,
mm/dd/yy
SWU-264 - Generic Annual DMR
Last revised 511712013

Additional Outfall Attachment
Outfall No.
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No ❑
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No ❑
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No ❑
Parameter, units
Total
Rainfall,
inches
Benchmark N/A
Date Sample .
Collected,
mm/ddlyy
SWU-264 - Generic Annual DMR
Last revised 511712013

1�0
MCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit. htW:I/portal.ncdeni-.org/web/Ir/npdes-stortiiwater/
Permit No.: N/C/_/_/—/—/_/_/—/ or Certificate of Coverage No.: N/C/G/ Z/ / Cam/ C�/-%-/6D/
Facility Name: Le) (S-ai± PG�G kc•ti z CcWM PIAOV
County: Al t� «oLvwy� Phone No. U - -1(0
Inspector: I%na.t-e LcTr�,-��-t'
Date of Inspection: Nnv
Time of Inspection: ku -3
Total Event Precipitation (inches): • 1Z—
Was this a "Representative Storm Event" er�"Meas�ureab�IeSt�®rm Event" s defined by the permit?
(See information below.)
❑ Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or ineasureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be s
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 s
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
1 obtains approval from the local DWQ Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature ofrPermittee or Designee)
Page 1 of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.) C-1
Receiving Stream: G f 2-c �L
Describe the industrial activities that occur within the outfall drainage area: AuZ cvw-ct4t
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C I � a,V- G\;r-7\1
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): I a v\..-&-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 2 3� 4 5
S. 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:
C2 ) 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:
1 C2) 3 4 5
7. Is there any foam in the stormwater discharge? Yes CN o
8. Is there an oil sheen in the stormwater discharge? Yes ED
9. Is there evidence of erosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
List and describe V-U
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