NCG200507 DMR SW (2)

STORMWATER DISC&GE OUTFALL (SDO)
GENERAL PERMIT NO. NCG200000
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE OFC VERA GE NO. NCG20 ©❑© 7
FACILITY NAME s be// n ve,Sk T c ar/erc
PERSON COLLECTING SAMPLES Q.
CERTIFIED LABORATORY Lab #
Lab #
COUNTY Pf rS0 fl
PHONE NO. (31(o)3319 —OCaQQ
Part A: Specific Monitoring Requirements
Mail original and one copy to: SAMPLES COLLECTED DURING
Division of Water Quality CALENDAR YEAR: rQ6 / L/
Attn: Central Files (This monitoring report is due at the Division no
1617 Mail Service Center later than 30 days from the date the facility
Raleigh, North Carolina 27699-1617
receives the sampling results from the laboratory.)
Outfall
No.
Date
Sample
Collected
mo/dd/ r
Total
Rainfall
inches
00530
00340 00556
00400
01113
01119
00980
01114
01094
Total Suspended
Solids
m
Chemical Oxygen Oil & Grease
Demand
m m
pH
S.U.
Cadmium
m
Copper
m
Iron
m
Lead 2
m
Zinc
m
Benchmark
-
-
100
120 30
6.0-9.0
0.001
0.007
N/A
0.03
0.067
. 5,
37
,5
000
a 7
42
0,06
6, 113
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.
z Total recoverable.
Only complete Part B if this facility uses more than 55 gallons of new motor oil per month.
Part B: Vehicle Maintenance Activitv Monitoring Requirements
Outfall Date
No. Sample
Collected
mo/dd/ r
Total New Motor Oil
Rainfall Usage
inches al/month
00530
00400
00556
Total Suspended
Solids
m
pH
S.U.
Oil & Grease
m
Benchmark -
- -
100
6.0-9.0
30
JAN 16 2015
E TRk FRES
R SECTION
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 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."
(Date)
NCG200000 DMR Form SWU-256
Page 1 of 1

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar YeargO/1-/
General Permit No. NCG200000
Certificate of Coverage No. NCG200U01X❑
This monitoring report summary is due to the DWQ Regional Office no later than March 1 sr of each
calendar year.
Facility Name:
County: Atr_sor�
Phone Number: (�3� )y 3 -d 69017
L
Total no. of SDOs monitored
Outfall No.
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No [Er
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No [t'
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
`Iron benchmark was removed due to variable ambient in -stream concentrations throughout State. However, 90% of ambient monitoring data collected
since 2004 by DWQ show background iron concentrations less than or equal to 2.1 mg/I. Storrnwater discharge iron concentrations greater than 2.1
mg/I may be contributing iron above background levels.
SW U-250NCG20-11.16.09
Total
-:
UL41L
Grease
Date Sample
...
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`Iron benchmark was removed due to variable ambient in -stream concentrations throughout State. However, 90% of ambient monitoring data collected
since 2004 by DWQ show background iron concentrations less than or equal to 2.1 mg/I. Storrnwater discharge iron concentrations greater than 2.1
mg/I may be contributing iron above background levels.
SW U-250NCG20-11.16.09

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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 knowina violations."
SignE
Date
Mail Annual DMR Summary Reports to Your Regional DWO Office:
DWO Regional Office Contact Information:
= Asheville Office.'..-..
[phone] w° b ale
225 Green Street
Fayetteville Office ...
[phone] al
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
[phone]
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
'Ile
Winston-Salem ......
[phone] F en
Central Office .........[phone]
�4SHEVILLE REGIONAL OFFICE
PAYETTEVILLE REGIONAL OFFICE
MOORESVILLE REGIONAL OFFICE
2090 US Highway 70
225 Green Street
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115 ,
[phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
LEIGH REGIONAL OFFICE
I ASHINGTON REGIONAL OFFICE
WILMINGTON REGIONAL OFFICE'.
3800 Barrett Drive
943 Washington Square Mall
127 Cardinal Drive Extension
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
.[phone]
[phone]
[WINSTON-SALEM REGIONAL
CENTRAL OFFICE
OFFICE
1617 Mail Service Center
7o preserve, protect
585 Waughtown Street
Raleigh, NC 27699-1617
and enhance
Winston-Salem, NC 27107
[phone]
worth Carolinas water..."
[phone]
SW U-250NCG20-11.16.09
0
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