NCG080960_DMR_20220712

Semi-annual Stormwater Di urge Monitoring Report
for brth Carolina Division of Water Resources General Permit No. NCG080000
Date submitted `?/12�20
CERTIFICATE OF COVERAGE NO. NCGO Q 2L(p Q SAMPLE COLLECTION YEAR 20�—
FACILITY NAME Nbc2 IAo?_GA-k i ''\\ �^ Jan-June Jul Dec
rbiJ SAMPLE PERIOD W©o'DGIN� 4 e.2vuin�HL
COUNTY }}gNovfr-� y-
PERSON COLLECTING SAMPLES N r ❑Monthly'_ (month)
CH IV ' O CLASS E]ORW E]HQW Trout PNA
LABORATORY N/A- ;Lab Cert.#
�� ,4UG ® 1 2022 ❑Zero-flow Water Supply QSq
Com ents on sample collection or anal .sis:
o �ISCt} (��S C hti' FILES ❑Other
DVVR SECTION
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Did this facility perform Vehicle Mainten bce Activities using more than 55 gallons of new motor oil per month?[]yes gno.
(if yes, report your analytical results in th table immediately below)
Part A:Vehicle Maintenance Areas Monitoring Requirements (If applicable)
�No discharge this period1
Outfall' Date 00530
No. Sample Collected, T tal Suspended 00400 00556
mo dd` r pH, Non-Polar-Oil and Grease/TPH.EPA ;An;nual
otor Oil Usage,
/Y Solids, mg/L Standard units Method 1664 SGT-HEM m L
Benchmark - 50 r 100 see permit Within 6.0-9.0 ( )� g/ average gal/mo
-15
Part B: Oil/water Separators and Second ry Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall Date 00556
No. Sample Collected, No -Polar Oil and Grease/TPH EPA Method 00530 00.400
mo/dd/yr Total Suspended Solids,
1664(SGT-HEM), mg/L pH,
Permit Limit _ 15 mg/L Standard.units
50 or 100 see permit 6.0—9.0
1 For sampling periods with no discharge at any single outfall,you must still submit this discharge monitoring report with a checkmar
S k here.
WU_250
last revised April 11,2013
�.,__. PaRe 1 of 2

STORM EVENT�CHARACTERISTICS:
Date (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. See General Permit text.
FOR PART AAND 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. SEEP ERMIT 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 Discharge"reports, within 30 days of receipt of the lab results(or at end of monitoring period
in the case of"No Discharge"reports)to:
Division of Water Resources
Attn: DWR 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
inquiry of th
qualified personnel properly gather and evaluate the information submitted. Based on my e person or persons who manage the system, or those persons directly
nd belief,true,accurate,and complete. I am aware that there are
responsible for gathering the information,the information submitted is,to the best of my knowledge a
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
7`
(Signature Permittee) (Date)
Additional copies of this form may be downloaded at: http //portal ncdenr orR/web/wq/ws/su/npdessw#tab-4
Iasi revised A
c1zrrT-' 5n