NCG080880 DMR SW

Semi-annual Stormwater Discharge Monitoring Reaort
for North Carolina Division of Water Quality General Permit No. NCG080000
New6W090902010Date submitted o2- /0 - Z045—
CERTIFICATE OF COVERAGE NO. NCG08 0 _c Q C SAMPLE COLLECTION YEAR ale -Ig
FACILITY NAME �e-<Aex SAMPLE PERIOD ❑ Jan -June E�:Iuly-Dec
COUNTY +n or ❑ Monthly' (month)
PERSON COLLECTING SAMPLES b DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY Lab Cert. # ❑Zero -flow ❑Water Supply [:]SA
Comments on sample collection or analysis: []Other
Part A: Vehicle Maintenance Areas Monitoring Requirements
PLEASE REMEMBER TO SIGN ON THE REVERSE -7),
No discharge this period'
Outfall
No.
Date 00530
Sample Collected, Total Suspended
mo/dd/yr Solids, mg/L
00400
pH,
Standard units
00556
Non -Polar Oil and Grease/TPH EPA New Motor Oil Usage,
Method 1664 (SGT -HEM), mg/L Annual average gal/mo
Benchmark
- 50 or 100 see permit
Within 6.0 — 9.0
15 -
i
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
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 SO or 100 see permlt 6.0-9.0
' 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 October 25, 2012
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STORM EVENT CHARACTERISTICS:
Date tot (first event sampled)
Total Event Precipitation (inches):
Date 1XIMig (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches): O• ( 3
Note: If you report a sample value in excess of the benchmark, you must implement Tier 3, Tier 2, or Tier 3 responses. See 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 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 cony of this DMR, including all "No Discharge" reports within 30 days of recelpt of the lab results for at end of monitorinayerlod 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
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 submping false information, including the possibility of fines and imprisonment for !mowing vlolatlons."
(Signature of
aQrs
(Date)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.or.g/web/wq/ws/su/npdessw#tab-4
SWU-250
Anthony Spalvied
Assistant Secretary
last revised October 25, 2012
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