NCG140080 DMR WW (5)

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000 Orig=State
CERTIFICATE OF COVERAGE NO. NCG14 0 0 8 0
FACILITY NAME: Chandler Concrete Co. — Eden Plant #105
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY:Pace Analytical Lab #633
OPTIONAL INFO:
Part A: Stormwater Monitoring Reauirements
Date Sample
Collected pH TSS
Outfall No. (mo/dd/yr OR ' (Standard
Units) _
(mg/L)
NO FLOW)'
1 1 No Flow
0. Copy - State
r 5 r 0 Copy - Plant
SAMPLE COLLECTION YEAB;28t r- 0 Copy - File
SAMPLING PERIOD: ® July -December ❑ January -June
COUNTY Rockingham
PHONE NO. ( 336) 635 - 0975
ADD TO LISTSERVE? ❑YES ❑NO EMAIL: _
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other: C
Event Total In Tier 2
Duration Rainfall° Monthly # of Months in Tier
Monitoring? 2 Sampling2
(minutes) (in) (Y/n),
N/A
LIVED .
No Qualifying Discharge Observed this Period FEB -0 3 2016
C NTRAL FILES
Due to limited operations a qualifying sample could not be obtained this period. I I 9WR SECTION
1 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.
3 TSS benchmark values are 100 mg/l, except when discharging to ORW, HOW, Trout, and PNA waters where they are 50 mg/l.
4 For each sampled measurable storm event the total precipitation must be recorded using data from an on-site rain gauge.
Permit Date: 7/1/2011-60/30/2016 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 year.
Outfall
No.
Date Sample
Collected
(mo/dd/yr)l
pH
(Standard
Units)
TPH using method Total Suspended
1664A SGT -HEM Solids
(mg/L) (mg/L)
Event
Duration
(minutes)
Total
Rainfalla
(in)
New Motor Oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
Sampling2
6-92
152 1002'3
-
-
-
-
-
N/A
*Vehicle Maintenance Not Performed this Location
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 OriMnal an lone copy of this DMR (includine all "No Flow" & "No Dischame" reports) within 30 days of receipt of sample (or at end of monitorine 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 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 diregtly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware tha ear signif' ant penalties for submitting false information, including the possibility of fines a imprisonment for knowing violations."
2? !6
(Signature bf Permittee) V (D te)
Permit Date: 7/1/2011-60/30/2016 Last Revised 7/13/11
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