NCG080033_DMR_20230418

CERTIFICATE OF
FACILITY NAME
COUNTY
PERSON COL E
LABORATORY
Comments on si
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted n
NO. NCGO8 V (3 -9 > 3 SAMPLE COLLECTION EAR
7 / ( SAMPLE PERIOD lan-June ❑ July -Dec
or ❑ Monthly'
LES DISCHARGING TO CLASS ❑ORW ❑HQW
I 6 Lab Cert. # ❑Zero -flow ❑Watt
ti nor analysis: RECEIVED mother
Part A: Vehicle Maintenance Areas Monitoring Requirements
,APR 25 2023
CENTRAL FILES
DVi/R SECTION
pply ❑SA
PLEASE REMEMBER TO SIGN ON THIt REVERSE 4
❑ No dischar�e this period'
Outfall
No.
Benchmark
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
S0 r:100see;permit
pH,
Standard units
Within.6:0-9.0 -
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
15
New Motor Oil Usage,
Annual average gal/mo
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 Bulk Stations and Terminals
0utfaII
No.
Permit Limit
Date
Sample Collected
mo/dd/yr
00556
' 00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
`!15
Total Suspended Solids,
mg/L
50or100 see permit
pHi
Standard
6.0-9.0,
units
1 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 revi ! ed October 25, 2012

STORM EVENT CHARACTERISTICS:
Date WvePrecipltatlon (first event sampled) ! ii
Total (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 General Permit text.
FOR PART 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 Discharge" reports within 30 days of receipt of the lab results for at end of monitorina nerind in
the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
i
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 accordancelwith 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 informationi submitted is, to the best of my knowledge and belief, true, accurate,I'I and complete. I am aware that
there are significant penalties for submitting false Information, including the possibility of fines and imprisonment for knowing violations."
yIILI jai 9Y.�ir 0if�
(Signature of Permittee) y(Date)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.org/web/wq/ws/­`su/npdessw#tab-4
SVVV-250 last revised October 25, 2012
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