NCG020515 DMR SW

ANNUAL SUMMARY DMR - STORMWATER
FEND TO. CENTRAL OFFICE
STORMWATER DISCHARGE OUTFALLS (SDO)
GENERAL PERMIT NO. NCG020000
*Report ALL STORMWATER Monitoring Data on this form (including No Flow and No Discharge and Permit Limit Violations) by MARCH 1 of each year.
CERTIFICATE OF COVERAGE NO. NCG02 0 Ste' S
FACILITY NAME: Z— , o •N C h �F a cA
PERSON COLLECTING SAMPLES v --d' M (t"
CERTIFIED LABORATORY fl-� Lab # 4 b.
Lab #
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR:
COUNTY 9 C1 u1g VA
PHONE NO.(i1a ` ) "2 ' �3_� °I RECEIVE®
ADD TO LISTERVE? YES NO Lj EMAIL:
TOTAL RAINFALL: INCHES JUN 2 2015
EVENT DURATION: MINUTES
CENTRAL FILES
TION
Outfall No.
Date Sample In Tier 2
# of Months in
Collected Monthly
Tier 2
(mo/dd/yr OR Monitoring? Sampling2
NO FLOW) (y/n)
Total Flow
'(MG)
Total Suspended
Solids
(mg/1)
DWK
a
Turbidity Settleable Solids
(NTU) (mi/1)
-
- - -
-
1001,4
See Footnote 's 0.1
0.
'If "NO FLOW"_or"NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here and the Date Range.
2 Per NCG02: Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
3 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier.1 or Tier 2 responses in the General Permit.
a TSS benchmark values are 100 mg/l except in ORW, HWQ, trout, and PNA waters where they are'50 mg/I.
'The discharge shall not cause an instantaneous measurement of the'turbidity of the receiving water to exceed: 10 NTU for freshwater streams, lakes, and reservoirs designated
as trout waters; 25 NTU for all lakes and reservoirs, and all salt waters; 50 NTU for all other streams and surface waters. Turbidity may be monitored at the SDO.
Alternatively, the permittee may choose to monitor turbidity in the receiving water, directly upstream and downstream of the SDO.
Permit Date: 1/1/2010-12/31/2014 Last Revised 01-19-10
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Part B: Vehicle Maintenance Activity Monitoring Requirements for -facilities using > 55 eat of.neW.. motor oil/month'on average
Outfall
No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
In Tier 2
Monthly
Monitoring? 2
(y/n)
# of Months
in Tier 2
Sampling.
New Motor Oil Total Flow
Usage . (MG)
(gal/month)
TPH using, Total Suspended
method I664A Solids,
SGT -HEM (mg/1)
(mg/1)
pH,
(Standard
Units)
- -
15 1003
6-9
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEENDENCES
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES []NO
HAVE YOU CONTACTED THE REGION? . YES ❑ NO
WHO AT THE REGION HAVE YOU SPOKEN WITH?
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE" & LIMIT
VIOLATIONS) BY MARCH I OF EACH YEAR TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOUMUST SIGN THIS CERTIFICATION FOR ANY INFORMA TION REPOR TED:
"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 gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
violations." c
(Signature of Permittee) (Date)
Permit Date: 1/1/2010-12/31/2014 Last Revised 01-19-10
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