NCG080161_DMR_20220425

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted 4,k\ ZS -ZpzZ
CERTIFICATE OF COVERAGE NO. N0008 O I I. SAMPLE COLLECTION YEAR al�o1�—
FACILITY NAME noS �. _ ti C cam_ ��r _ RECRVESE PERIOD ©Jan-June ❑July-Dec
COUNTY or ❑Monthly' (month)
PERSON COLLECTING SAMPLES CN- MAY 0 2 Z69CHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY V'� . F �F Lab Cert.R y0'2_ CENTRAL FILE ❑Zero-flow [—]water supply [:]SA
Comments on sample collection or analysis: DWR SECTION ®Other Oa" -P-ea PI L-P r"
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_yes Xno
(if yes, report your analytical results in the table immediately below)
Part A:Vehicle Maintenance Areas Monitoring Requirements(if applicable) ❑No discharge this period'
Outfall Date 00530 00400 00556
No. Sample Collected, Total Suspended pH, Non-Polar Oil and Grease/TPH EPA New Motor Oil Usage,
mo/dd/yr Solids, mg/L Standard units Method 1664(SGT-HEM),mg/L Annual average gal/mo
Benchmark 50 or 100 see permit Within 6.0-9.0 15
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals(If applicable)
Outfall Date 00556 00530 00400
No. Sample Collected, Non-Polar Oil and Grease/TPH EPA Method Total Suspended Solids, pH,
mo/dd/yr 1664(SGT-HEM),mg/L mg/L Standard units
Permit Limit 15 50 or 100 see permit 6.0-9.0
�AcS a2S'�+�'O�c211 V��LI.o_
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 April 11,2013
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STORM EVENT CHARACTERISTICS:
Date!lW..(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. Se
e ee General Permit text.
FOR PART A AND PART$MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS_.SEE PERMIT PART if SECTION B.
• 2 EXC-EDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTI
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ON B.
IF YES,HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES 0 NO CJ NO Q
REGIONAL OFFICE CONTACT NAME:
tNai!an or1 ina!and one co o this DMR includingall"No Dischnr e"re oils within 30 the case of plYo Disc_h�ircre"re�vrtsl to: do s o recei t o the lab results tot at end o monitorin eriod in
Division of Water Quality
Attn:DWQ Central Files
1617 Mail Service Center
Raleigh,North Carolina 27699-1617
YOU MUST SIGN THIS CEfiTIFiCATION 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
directly responsible for gathering the information,the intormation submitted is,to the best of my knowledge and-belief',true acc r the system,or those persons
There are significant penalties for submitting false information,including the possibility of fines and imprisonment for kn � u ate,and complete. I am aware that
q , F owing Violations."
A '[lt 1
(Signature of Permittee) �
(Date)
Additional copies of this form may be downloaded at:ht�pprtal.ncdenr.ore/web vy. ws synpdessw#tab-A
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i
S W i.1-250
last mviscd April 11,2013
Page 2 of 2