NCG080715_DMR_20200707

Semen-annua0 Stormwater Discharge Monftorron
for North Carrdina Division ®f Water - QuMo�V �e rrM Perrmk No. NCG080000
Date submitted
CERTIFICATE OF COVERAGE �NO. C(3,8 0 - t S SAMPLE COLLECTION YEAR
FACILITY NAME Z � SAMPLE PERIOD Q- aann-June [❑ July -Dec
COUNTY or ❑ Monthly' (month)
PERSON COLLECTING SAM LES r �t,•� DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout PNA
LABORATORY w► s Lab Cert. # -7 ❑
❑Zero -flow [:]WaterSupply ❑SA
Comments on sample collection or analysis: ❑Other
Part A: Vehicle Maintenance Areas Monitoring Requirements
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
Total Suspended
Solids, mg/L
PHO
Standard units
Benchmark
-
50 or 100 see permit
Within 6.0 — 9.0
PLEASE REMEMBER TO SIGN ON THE REVERSE
❑ No discharge this period'
00556
Non -Polar Oil and Grease/TPH EPA New Motor Oil Usage,
Method 1664 (SGT-HEM), mg/L Annual average gal/mo
i5
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 Bulls Stations and Terminals
Outfall Date 00556 00530
No. Sample Collected, Non -Polar Oil and Grease/TPH EPA Method Total Suspended Solids,
mo/dd/yr 1664 (SGT-HEM), mg/L mg/L
Permit Limit - 15 50 or 100 see toermif
00400
pH,
Standard units
6.0 — 9.0
1 For sampling periods with no discharge at any single outfall, you must still submit this discharg
e monitoring report with a checl<marl< here.
SWU-250
last revised O• 'per 25, 2012
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r
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out thisform, please visit. httll://12ortal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
Permit No.:
Facility Name: _
County:
Inspector:
Date of Inspection:
Time of Inspection:
J
or Certificate of Coverage No.: NV/C/G/ o/ Q/ g 7/ ± / -�l
Phone No. $!o -e&;Z- Goc:v
Total Event Precipitation (inches): t 1�
Was this a "Representative Storm Event" or "Measureable Storm F
(See information below)YzPt"as defined by the permit?
,
RECEP ,
Yes ❑ No JUL 2 0 2Q U
Please verify whether i QElfiCTiW1f9 i i�oring must be performed during a "representative storm
event" or "measureable%& +&Jtl' 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 j
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 t�k-sigp"re, I/q/tify that this report is accurate and complete to the best of my knowledge:
of Permittee or Designee)
SWU-242, Last modified 10/25/2012
Page 1 of 2

1. Outfall Description: 4L ( /
Outfall No. / Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge uging basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: I to
3. Odor: Describe any distinct odors that the,ilischarge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): /ttJ ore e. ✓
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
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:
0 2 3 4 5
b. 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 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes (NJ
8. Is there an oil sheen in the stormwater discharge? Yes oNo
9. Is there evidence of erosion or deposition at the outfall? Yes CNo)
10. Other Obvious Indicators of Stormwater Pollution:
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