NCG140086 DMR SW (2)

STORMWATER DISCHARGE OUTFALL (SDO) - Semi-Annual MONITORING FORM
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GENERAL PERMIT NO. NCG140000 Ori 9-State
0 Copy-State
0 Copy-Plant
CERTIFICATE OF COVERAGE NO. NCG14 0 0 8 6 SAMPLE COLLECTION YEAR:2015 0 Copy-File
FACILITY NAME: Chandler Concrete Co.- Pittsboro#111 SAMPLING PERIOD: July-December ®January-June
PERSON COLLECTING SAMPLES: COUNTY Chatham
CERTIFIED LABORATORY:Pace Analytical Lab#633 RECEIVED PHONE NO. ( 919) 542 -4242
OPTIONAL INFO: 31 2.015 DISCHARGING TO LISTSERVE? FIVES NO EMAIL: _
DISCHARGING TO CLASS: fSA HQW [PNA (Trout ®Other: WS-V,
CENTRAL FILES NSW
Part A:Stormwater Monitoring Requirements DV1R SECTION
Date Sample In Tier 2
pH Event Total
Collected TSS n Monthly #of Months in Tier
Outfall No. (Standard Duration Rainfall 2
(mo/dd/yr OR (mg/L) Monitoring? 2 Sampling
NO FLOW)' Units) (minutes) (in) (y in)
6-92 1002'3 - - - -
1 NO FLOW - N N/A
No Qualifying Discharge this Period
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.
2 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/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 year.
In Tier 2
pH TPH using method Total Suspended Event Total New Motor Oil #of Months
Outfall Date Sample a Monthly
(Standard 1664A SGT-HEM Solids Duration Rainfall Usage in Tier 2
No. Collected Monitoring? 2
(mo/dd/yr)1 Units) (mg/L) (mg/L) (minutes) (in) (gal/month) NM) Sampling
6-92 152 1001,3 - - - - -
- - - N / A - - - No vehicle maintenance performed at facility - - -
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 copy 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 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 r- ••nsib a for gat ring the information,the information submitted is,to the best of my knowledge and belief,true,accurate,and complete. I
am aware - - si ' is t pe ties for submitting false information,including the possibility of fines and imprisonment for knowing violations."
(Sign.ture of Per ittee (D te)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
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