NCG020012 DMR SW

II ANNUAL SUMMARY DMR - STORMWATER II
SEND TO CENTRAL OFFICE*
STORMWA TER DISCHARGE OUTFALLS (SDO)
GENERAL PERMIT NO. NCG020000
*Report ALL STORMWA TER Monitoring Data on this form (including No Flow and No Discharge and Permit Limit Violations) by MARCH l of each year
CERTIFICATE OF COVERAGE NO. NCG020012 SAMPLE COLLECTION YEAR: 2014
FACILITY NAME: Burlington Quarry COUNTY: Alamance
PERSON COLLECTING SAMPLES: Josh Turner PHONE NO. 336-584-8875
CERTIFIED LABORATORY: PACE ANALYTICAL Lab #12 ADD TO LISTERVE? YES❑ NO❑ EMAIL:
Part A: Stormwater Monitoring Requirements
Outfall
No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
In Tier 2
Monthly # of Months in Total Flow
Monitoring? Tier 2 (MG)
(/n) Sampling2
Total Suspended Total Event
Solids Turbidity4 Settleable Rainfall Duration
(mg/1) (NTU) Solids (ml/1)
(in)
-
-
- - -
1003'4 See Footnote 3,4 0.1 3
Existing Sediment Basin
No Discharge
Existing Sediment Basin
No Discharge
It "NO hLOW or "NO DISCHARGE," enter "NO FLOW" or "NO DISCHARGE" for each outfall here and the Date Range.
2Per NCG02: Tier 2 Monthly Sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 I a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Teir 1 or Tier 2 responses in the General Permit.
4TSS benchmark values are 100 mg/1 except in ORW, HWQ, trout, and PNA waters where they are 50 mg/l.
5The discharge shall not cause an instantaneous measurement of the turbidity of the receiving water to exceed: 10 NTU for freshwater streams, lakes, and reservois designated
as trout waters; 25 NTU for all lakes and reservois, and all salt water; 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 01-21-11
Page 1 of 2

Part A: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month on average
Date Sample
Outfall Collected
No. (mo/dd/yr OR
NO FLOW)'
In Tier 2
Monthly # of Months in
Monitoring? Tier 2
(y/n) Sampling
New Motor
Oil Usage
(gal/month)
Total Flow TPH using method
(MG) 1664A SGT -HEM
(mg/1)
Total Suspended
Solids
(mg/1)
pH Total Event
(Standard Rainfall Duration
Units) (in)
- - 15 3 100 3
6-9 3
Shop Basin No Discharge
Shop Basin No Discharge
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO C]
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 1 OF EACH YEAR TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOUMUST SIGN THIS CERTIFICATION FOR ANYINFORMA TION REPORTED:
"1 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 sumbitted. 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 imprisionment for knowing
(Signafur
Permit Date:
0-12/31/2014
(Date)
1/2/2015
Last Revised 0 1 -21 -11