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'Semi-annual Stormwater Uischaree Monitoring Report
for North Carolina Division of Water Quality General Permit No.'NCG080000
Date su muted — O
CERTIFICATE OF COVERAGE NO.NCG08 0 4 1 1 SAMPLE COLLECTION YEAR �_d ZZ
FACILITY NAME REPUBLIC SERVICES-TROY s SAMPLE PERIOD Jan-June []July-Dec
COUNTY MONTGOMERY or Q Monthly' .(month)
PERSON COLLECTING SAMPLES DAMES M.WILSON DISCHARGING TO CLASS QORW ❑HRw pTrcut pPIVA
LABORATORY ENCO Lab Cert.# T7 11 []Zero-flow []Water Supply `FISA
Comments on sample collection or analysis: ®Other C
JUL
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A:Vehicle Maintenance Areas Monitoring Requirements DWR 58C1 ION ❑No discharge this period"
Outfall Date 00530 00400 . . . OOS56
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_ -. $0!or.100see,permlt Wlthln:6,d-9.0 15 -
#1 i
#2 tvz=;
Did this facility perform Vehicle Nlairntenance 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 00556 00530 00400
No. Samle Collected,
p Non-Polar 01.1 and Grease/TPA:EPA Method Total Suspended Solids; pH;
d o/dd/yr 1664.(SGT HEM),mg/L. MIKA Standard units
Permit1imit - 15 50 or 100 see permit 6.0-9.0
#1
#2
1 For sampling periods with no discharge at any single outfall;you must still submit this dischargemonitoring report with a eheekmark here.
SWU-250. last revised October 25;2012
Page l of 2.
STORM Ee-.qT CHARACTERISTICS:
Date(first event sampled)
Total Event Precipitat he s) .`"► '
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 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 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"No Discharae"resorts within 30 days of receipt of the lab results for at end of monitorina period in
the case of"No Discharae"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 gatherin he information,the information submitted is,to the best of my knowledge and belief,true,accurate, and complete. I am aware that
there are signifi ant penalties r submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permitt ) (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-250 last revised October 25,2012
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