NCG140266 DMR SW (4)

f,
STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140266
FACILITY NAME: Thomas Concrete of Carolina -Morrisville Plant_
PERSON COLLECTING SAMPLES Susan Bostian
CERTIFIED LABORATORY ESC Lab # ENV 375_
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring R
Date Sampl
Outfall No. :Collected
(mo/dd/yr(
NO FLOW)
001 12/15/14
002 12/15/14
003 12/15/14
irements
Total.
Monthly
I?H
TSS
(Standard
(mg/L)
Units). .;
z°
2 Samplin
6-9z
10ol"',
7.06
1.4
9.97
85
9.43
230
SAMPLE COLLECTION YEAR: 2014
SAMPLING PERIOD: ® July -December ❑ January -June
COUNTY Wake
PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: ®SA ❑HQW ❑PNA ❑Trout ❑Other
Tvent,.
Total.
Monthly
In Tier 2
# of Monthsin Tier
Duration
Rainfall
Monitoring?
z°
2 Samplin
(minutesg
(in) :
(Y/nf
,e
60
0.6
y
1
60
0.6
y
1
60
0.6
v
1
09 20155
RAL FILES
SECTION
' If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
Z 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. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
4 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I.
For each sampled measurable storm event the total precipitation must be recorded using data from an on-site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
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Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar yeah.
Outfall
No.
Date Sample
Collected1
(mo/dd/yr)
pH TPH using method Total Suspended Event Total New Motor Oil In Tier i2 # of Months
a
(Standard 1664A SGT -HEM Solids Duration Rainfall Monthly Usage � in Tier 2
Units) (mg/L) (mg/L) (minutes) (in) (gal/month) Monitoring? Sampling2
(y/n)I
6-92 152 1002'3
i
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
REGIONAL OFFICE CONTACT NAME:
Mail Original and one coov of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end_ of monitoring period
in case of "No Flow") 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 i
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage tf
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate,
am aware that theT ave significant pee ^alties)for submitting false information, including the possibility of fines and imprisonment for knowing violation
e . "`' f(� 12/29/2014
(Signature of Permittee)
(Date)
lesigned to
e system, or
and complete.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
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