NCG140218 DMR SW (2)

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140218 SAMPLE COLLECTION YEAR: 2016
FACILITY NAME: Thomas Concrete of Carolina -Durham Plant SAMPLING PERIOD: ❑ July -December ® January -June
PERSON COLLECTING SAMPLES Kevin Kelt COUNTY Durham
CERTIFIED LABORATORY ESC Lab # ENV 375 PHONE NO. [phone]
Lab # ADD TO LISTSERVE? []YES ®NO EMAIL:
OPTIONAL INFO:---FebrimAj Monitoring event DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other,
Part A: Stormwater Monitoring Requirements
Date Sample
Collected
Outfall No. ,
(mo/dd/yr OR -Monitoring?
.. ✓ NO FLOW)1 f.
pH TSS s
(Standard
Units
In Tier 2;
Event Total
Duration Rainfall4 Monthly, " # of Months in Tier
Z .
Monitoring? � .2,Sampling
(minutes) (in)
(Y/n)�
_
6-92 x j002,1
001' No Discharge
y 23
- If NO hLOW" 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/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
Page 1 of 2

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/yI
pH
(Standard
Units)
6-92
TPH using method
1664A SGT -HEM
(mg/L)
152
Total Suspended Event
Solids Duration
(mg/L) (minutes)
1002'3 -
Total New Motor Oil In Tier 2 # of Months
a Monthly
Rainfall Usage in Tier 2
Monitoring? 2
(in) (gal/month) (y/n) Sampling
- - - -
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:
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27
"I certify, under penalty of I
assure that qualified persor
those persons directly resp(
am aware that there are sig
1: L" ?i
(Signature of Permittee)
Permit Date: 7/1/2011
1617
R ANY INFORMATION REPORTED:
�, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
�l properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
sible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
fent penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
2/29/2016
(Date)
Last Revised 7/13/11
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140218
FACILITY -NAME: Thomas Concrete of Carolina -Durham Plant
PERSON COLLECTING SAMPLES Kevin Kelt
CERTIFIED LABORATORY ESC Lab # ENV 375_
Lab #
OPTIONAL INFO: February Monitoring event
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2016
SAMPLING PERIOD: ❑ July -December ® January -June
COUNTY Durham
PHONE NO. [phone]
ADD TO LISTSERVE? DYES ®NO EMAIL:
DISCHARGING TO CLASS: [:]SA ❑HQW ❑PNA ❑Trout ®Other,
Date Sample
Collected '
Outfall No.
(mo/dd/yr OR'
NO FLOW)
pH TSS
(Standard
Units) (mg/L)
InTier2
Event Total 4 Monthly # of Months in Tier
'Duration Rainfall
Monitoring? 2 Sampling2
(minutes) (in) " (Y/n)
_ -
6=92 1002.1
001 No Discharge
y 24
It "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/I, except when discharging to ORW, HOW, Trout, and PNA waters where they are 50 mg/l.
° 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
Page 1 of 2

Dart R- Vnhirlu Mnintnnnnrn Artiuitu Mnnitnrinv Ramdramantc fnr fnrilitiac ucina > 55 aal of naw mntnr nil/month — averaeed over a calendar vear.
Outfall .
No.
Date Sample
Collected1
(mo/dd/yr)
pH TPH using method Total Suspended Event Total New Motor Oil In Tier 2 # of Months
a Monthly
(Standard 1664A SGT -HEM Solids Duration Rainfall Usage in Tier 2
Units) (mg/L) (mg/L) (minutes) (in) (gal/month) Monitoring? Sampling2
(y/n)
6-92 15 100 ,3 - - - - -
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)?
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
I
in case of "No Flow") tc
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 2
"I certify, under penalty
assure that qualified pe
those persons directly r
am aware tjf-athere an
.19',
(Signature of Permittee)
"1
17
within 30 days of
YES ❑ NO
sample (or at end of monitorin
law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
nnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system; or
onsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
gnificant penalties�or submitting false information, including the possibility of fines and imprisonment for knowing violations."
3/31/2016
(Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2