NCG140350 DMR SW (8)

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140350
FACILITY NAME: _Thomas Concrete of Carolina -Wake Forest Plant_
PERSON COLLECTING SAMPLES Andrew Rodak
CERTIFIED LABORATORY ESC Lab # ENV 375_
Lab #
OPTIONAL INFO: May Monitoring Event
>art A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2015
SAMPLING PERIOD: ❑ July -December ® January -June
COUNTY Wake
PHONE NO. [phone]
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW ❑PNA ❑Trout ®Other.
Date Sample ,` � �� ,� •' In Tier 2
pHA Event :Totals 4
Collected TSS4.'wMonthly
Outfall No (rrio/dd/yr, OR (Standard.- m . Duration Rainfall =
i ? Units) g/) (minutes)(�n) a Momtor.�ng
'152
ANO FLOWN ;. (Y/n)
� ��
# of onths inTer
r ter. z
�2 Sampling
amu.,
6'9 :.,.
D
001
No Discharge
y
g
` 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, 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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o -,r+ c. ens:.,+n—rn er+i,d+„ Ninnitnrino Rcnuiromantc fnr fnriiitiac iscino �o SS onl of nPw motor oil/month — averaeed over a calendar vear.
Outfall Date Sample
No. Collected
(mo/dd/yr)1
pH
(Standard
Units)
TPH using method
1664A SGT -HEM
(mg/L)
Total Suspended Event
Solids Duration
(mg/L) (minutes)
Total New Motor Oil In Tier 2
Monthly
Rainfall" Usage
(in) (gal/month) Monitoring?
(y/n)
# of Months
in Tier 2
Sampling2
6-92 152 1002.3
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:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina i
"I certify, under penalty
assure that qualified pei
those persons directly n
am aware that there axe
(Signature of Permittee)
Permit Date: 7/1/2011
4
reoorts) within 30
1617
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
nifica enaMis„1
for submitting false information, including the possibility of fines and imprisonment for knowing violations.”
?," �" ` 6/8/2015
(Date)
Last Revised 7/13/11
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