NCG020152 DMR SW (3)

AL SUMMARY DMR - STO
SEND TO CENTRAL OFFICE.*
STO"WATER DISCHARGE OUTFALLS (SDO)
GENERAL PERMIT NO. NCG020000
*Report ALL STORAIWATI;R Monitoring Data on this form (including NoTFloiv and No Discharge and Permit Limit Violations ) byMARCH 1 of each year.
CERTIFICATE OF COVERAGE NO. NCG020152 SAMPLE COLLECTION YEAR: 2015
FACILITY NAME: Jamestown Quarry COUNTY: Guilford
PERSON COLLECTING SAMPLES: Dennis Cobb PHONE NO. 336-886-5015
CERTIFIED LABORATORY: PACE ANALYTICAL' Lab #12 ADD TO LISTERVE? YES❑ NO ❑ EMAIL:
Part A• Stnrmwnter Mnnitnrinn RAn..;rP., -+.
Outfall
No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)t
In Tier 2
Monthly
Monitoring?.
/n
# of Months in
Tier 2
Sampling
Total Flow
(MG)
Total Suspended
Solids
(mg/1)
Turbidity°
(NTU)
Settleable
Solids (ml/1)
Total
Rainfall
(in)
Event
Duration
hrs
-
-
-
-
- -
1003'4
See Footnote 3'°
0..13
Jan. -Jun. Pit Discharge
Jul. -Dec. Pit Discharge
6/2/15
12/14/15
N
N
0.02
0.013
ND
5
1.2
10.7
ND
ND
0.3
0.18
4
8
elf "Nn FI nW" nr °irn ntcruenr_c ..ern ni ns.n _
..� �...., .mow.— ..Va atu naugc.
ZPer.NCG02: Tier 2 Monthly Sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Teir I or Tier 2 responses in the General Permit.
4TSS benchmark values are 100 mg/I except in ORW, HWQ, trout, and PNA waters where they are 50 mg/l.
-The discharge shall not cause an instantaneous measurement of the turbidity of the receiving water to exceed: 10 NTU for freshwater streams, lakes, and reservois designated
as trout waters; 25 NTU for all lakes and reservois, and all salt water; 50 NTU for all other streams and surface waters. Turbidity may be monitored at the SDO.
Alternatively, the permittee may choose to monitor turbidity in the receiving water, directly upstream and downstream of the SDO.
Permit Date: 1/1/2010-12/31/2014 Last Revised 01-21-11
Page 1 of 2

Part A: Vehicle Maintenance Activity Monitoring Requirements for facilities usine > 55 eal of new motor oil/month on nveraoe
Outfall
No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
In Tier 2
Monthly.
Monitoring?
(y/n)
# of Months in
Tier 2
Sampling
New Motor
Oil Usage
(gal/month)
Total Flow. TPH using method
(MG) 1664A SGT -HEM
(mg/1)
Total Suspended
Solids
(mg/1)
pH Total Event
(Standard Rainfall Duration
Units) (in)
15 3 100 3
6=9 3
Jan. -Jun. Comin led Wa
25.0
Jul. -Dec. Comingled Wat
25.0
i
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES NO Er'
HAVE YOU CONTACTED THE REGION? YES Q NO E]
WHO AT THE REGION HAVE YOU SPOKEN WITH?
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW" "NO DISCHARGE" & LIMIT
VIOLATIONS) BY MARCH 1 OF EACH YEAR TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
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 sumbitted. Based on my inquiry of the person or persons who manage the
system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate,
and complete. re that there are significant penalties for submitting false information, including the possibility of fines and imprisionment for knowing
violatio . "
--.— 1/6/2016
(Signatur f Perm' e) (Date)
Permit D e: I/1/20 -12/31/2014 Last Revised 01-21-11
Page 2 of 2