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Home My WebLink AboutNCG210407 DMR SWSTORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT GENERAL PERMIT NO. NCG210000 —a CERTIFICATE OF COVERAGE NO. NCG21[aREFO]A FACILITY NAME "h' r> PERSON COLLECTING SAMP4S Chsan CERTIFIED LABORATORY ruf.--PWiaIj4*cA.l Lab# 40 . . Lab # Part A:'S pe8fic Monitorin' `Re u ` < irementsi' SAMPLES COLLECTED DURING CALENDAR YEAR: 00 K (This monitoring report is due at the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) " PHONE NO. (Sag) 1— JAN 0 4 2016 PLEASE SIGN ON THE REVERSE 4 CENTRAL FILES N `� ©utfa�il)I- •� 1 � - . f~ e : ;' _ �� -00530��,� � 40UF' x� �'�r� ��'��9. .- EY..:' a ,r � �. r..,e,...::>f t�z�Orr cx:.t.n: all,:>TotaltSuspendecl Sohd;;t Iii ;�,� x - p "� 1 a ca Oxygenwemand,(CQp:),�" r. 4 tl-lel�� :amu rr - � w /, s� _ : _. ��. �� _ �,.5 d�uruts^•� � la`f�' �" r� � -�.�� k1� r f c� `� � ��h{ 'a4� 0 �. _ _ _ .. re s M �Wxrthin`t6.0�'� 9.0�� _.. .._ -. (a0 Div14 1 Ttvote: u a value is to excess or the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. 'Monitoring is required otily frthe facility stores exposed piles of sawdust, wood chips, bark, mulch, or other similar material on site for longer than seven (7) days. A facility that does not retain exposed (either exposed`to incident precipitation or exposed to stormwater run on) piles of sawdust, wood chips, bark, mulch, or other similar material on site for more than seven (7) days before removing tte:material is not required to monitor for the parameters in Table 1 of the General Permit. If at any time the material is not removed within thisrtime frame, the facility must begin analytical monitoring immediately. (Reminder: This condition does not exempt any facility from qualitative monitoring of SDOs.) If the facility removes.such materials within seven days to meet the monitoring exemption, the Permittee shall record and maintain in the facility's SPPP a log which documents, at a minimum, the dates when material is gene'rafed and removed, how removed, and by whom. The log must be sufficient to establish that no materials were exposed for longer than seven days. For record-keepmg purposes, the Permittee`inay also maintain in the SPPP this form with the signed certification below: "Based .upon my mqi iry,of the,person or persons: directly responsible for managing compliance with the permit requirement for analytical monitoring, I certify that to the best of'my,'knowledge and beliefno piles of sawdust, wood chips, bark, mulch or other similar materials were stored exposed (either (o incident precipitation or to stormwater run on) for longer than seven(?) days before removal since filing the last discharge monitoring report." Name (Print name) Title (Print title) (Signature) (Date) S WU-245-110408 Page I of 2 DID THIS FACILITY PERFORM VEHICLE MAINTENANCE ACTIVIES USING MORE THAN 55 GALLONS OF NEW MOTOR OIL PER MONTH, ON AVERAGE, IN THE CALENDAR YEAR? ❑ Yes No (If yes, complete Part B) Part B: Vehicle Maintenance Activity Monitoring Requirements YCollected,Total `enclunark man nfall,NevMdtor M.P>'�00556 ;Oily sage; pmt+ �Oil�andGrese, .oal n"al�a �� ar ge�gaUmo� ��~Stan,,,sdacd�units-r mg/I. - �3 OU530 - . uspendedfSohds?p *Note: If you report a value in excess of the benchmark value, or outside the benchmark range (for pH), you must implement Tier-Lor.Tier-2 responses in the_General.Permit. Mail original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED IN PARTS A AND/OR B: "I certify, underpenalty 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 onmy inquiry ioUthe person or - persons who manage the system, or those persons directly responsible for gathering the information, the inforriiation 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 o f es and ' prisonment for knowing violations." (Ri mittee) (Date) S WU-245-110408 •2of2.