NCG080134 DMR SW

Semi-annual Stormwater Discharae Monitorina Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted
CERTIFICATE OF COVERAGE NO. N G
FACILITY NAME
COUNTY
PERSON COLL NG A L S (
LABORATORY 'lab Cert. #
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR .0 `J
SAMPLE PERIOD ®,Ian -June ❑ July -Dec
or []Monthly' fmonthl
DISCHARGING TO CLASS MORIN ❑HQW []Trout ❑PNA
❑Zero -flow ❑Water Supply (]SA
RECEIVED ❑Other
JUL 2 9 2015 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons qF, tioWgr month? _ yes _no
(if yes, report your analytical results in the table immediately below) DWR SECTION
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
❑ No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530 00400 00556
Total Suspended pH, Non -Polar Oil and Grease/TPH EPA New Motor Oil Usage,
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 i5 -
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556 00530 00400
Non -Polar Oil and Grease/TPH EPA Method Total Suspended Solids, pH,
1664 (SGT -HEM), mg/L mg/L Standard units
Permit Limit
-
15 50 or 100 see permit 6.0-9.0
I 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 —(—I II I I (first event sampled) _(
Total Event Precipitation (inches): _4k �r A
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 ANY ONE 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 receiot of the lob results for at end of monitoring period in
the case of "No Discharge" reoorts) 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:
N 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 submitte ased on my Inquiry of the person or persons who manage the system, or those persons
directly responsible for gathering the information, the information subm5tetf is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that
there are significant penalties for suym-i4ing!3lsq i0f Wm4Aion, inclu ' g the possibility of fines and imprisonment for knowing violations."
(Signature of
to 1.
(Date)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.oriz/web/wq/ws/su/npdessw#tab-4
S WU-250
last revised April 11, 2013
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