NCG140089 DMR SW (3)

STORMWATER DISCHARGE OUTFALL (SDO) - Semi' Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000 Orig -Sate
tate
�p Copy
�P 0 Copy - Plant
CERTIFICATE OF COVERAGE NO. NCG14 0 0 8 9 SAMPLE COLLECT N YEAR: 015 0 Copy- File
FACILITY NAME: Chandler Concrete Company, Inc. - Durham #606
PERSON COLLECTING SAMPLES: Anthony Warash
CERTIFIED LABORATORY:Pace Analytical Lab #633,
OPTIONAL INFO:
Part A: Stormwater Monitorine Reauirements
SAMPLING PERI D:- ®Ju -December ❑ January -June
COUNTY Durha
PHONE NO.( 336) 226 - 1181
ADD TO LISTSERVE? ❑YES ®NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®OtherWS-V,
NSW
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.
s TSS benchmark values are 100 mg/I, 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: 7/1/2011-60/30/2015 Last Revised 7/13/11
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Outfall No..
Date Sample'
Collected
(mo/dd/yr OR
NO.FLOW)1
pH
(Standard Units)
TSS
(mg/L)
Event
Duration
(minutes) -
Total 4 -
Rainfall
(in)
In Tier 2
Monthly
Monitoring?,
lY/nl
# of Months in
Tier 2 Sampling2
6-92
1002,3
-
i
1
8/31/15
7.4
ND
45
.40
N
N/A
-.,EIVED
Discharge due to storm event/PW
commingles with SW
SW and PW samples share same outfall
CENTRAL
FILES
CUIVIR
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.
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.
s TSS benchmark values are 100 mg/I, 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: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Dirt R• Vnkirin Mnintpnnnrc ertivitu Mnnitnrina Panieirpmantc fnr farilitiac ucinP �- SS Pal of nPw mntnr nilfmnnth — averaeed over a calendar vear.
Outfall
No.
Date Sample
Collected
(mo/dd/yr)1
In Tier 2 .
PH TPH using method Total Suspended Event Total New Motor Oil
a Monthly
(Standard 1664A SGT -HEM Solids Duration Rainfall Usage , .
Monitoring?
Units) (mg/L), (mg/L) (minutes) (in) (gal/month) (Y/n)
# of Months
in Tier 2 . -.
-r
Sampling..;
6-9? 152 1002,3
Testing Not Required — No vehicle maintenance performed on site
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 -,cop 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: DWQCentral: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 personni I properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directl r sible for g theri the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware t ere rl gnifi atSt p Iti f mi ing false information, including the possibility off' es a imprisonment for knowing violations."
/ 2 ��
(Sign ture of Permittee) (D te)
Permit Date: 7/1/2011-60/30%2015 Last Revised 7/13/11
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