NCG020749 DMR SW (8)

*Report ALL STORA4WATER Monitoring Data on this form (including No Flow and No Discharge and Permit Limit Violations) by MARCH 1 of each ear.. —�
CER';<'ll1>1IdCATE, OF COVERAGE, No. NCGO2.0, 2
--
FACILITY NAME- • m1 ! � s t� L
-PERSON COLLECTING SrAMPLES, I h
CERTIFIED LABORATORY, ab #
Lab #
SAMPLE COLLEC-TION YEAR.: Q/
COUNTY 90MA i -66 -
PHONE NO.
ADD TO LISTSERVE? YES 9 NO El >El',�AIL: Vne 114", '
'art A: Stormwater ivIonazor►nRnelitilremullui-
IDate Sample
Outfall Collected
-,,,,In 'Tier 2
Monthly
# of Months in
" Tier 2 Total Flow
Tbtal,Suspended Turbidity
Settleable
Totalow
1<3aitat'all
No, (mo/dd/yr OR
Monitoring?
,
Sampling 41'�7fG)
Solids NI
(mom) ( �
Solids (ml/1)
No FLOW))
(y/n)
100-1.4 See 1Footnote"'s
0.11
p _��
Q
dW l,• i�
Y .i df✓ NY
_.
A tQ M
rte....
Event
Duration
(minutes)
'if "NO FLOW" or "NO DISCHARGE, Enter -"NO -FLOW" or "NU Ul6l:riAt{UZ__ ror each outdiut nolo and the bate t�aicrj
2 Per NCO02- Tier 2 Monthly `sampling shall be done until 3 consecutive samples -are below the benchmark or within the benchmark range
3 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you mustimplentent the Tier t.or Tier 2 responses -iii the-Geneirrl Yerrrrit.
8 TSS benchmark values are 100 mg/l except in ORW, HWQ, trout, and PNA waters where they are -50 MO.
5 The discharge shall not cause an instantaneous measurement of the turbidity of the receiving water -to exceed: it) NTU-fpr freshwater streams, lakes, utid reservoirs desi� uut..,
as trout waters; 25 NTU for all lakes and'reservoirs, and all salt waters,"50 NTU.for all other streams and surface waters. Turbidity may be inonitorcd at the Sl3u
Alternatively, the perinittee may choose to monitor turbidity in the receiving water, directly upstream and downstteam of the SDO.
01-02-1-1
Permit Date: 1/1/2414-12/31/2014 Last itevis.rt1
tpnha I nr,

#art B: Vehicle Maintenan -Activity MO
Date Sample, In Tier Z
Outfall Collected Monthly,
No. (mo/dd/yr OR Monitoring?
NO FLOW): ' (-*/n)
tor Re nirements
of Months
#
in Tier2
Sampling2,
for facilities
New Ii<Iatar
®il Usage
al/month)
itsin > 55 gal of new moror Outman
Total flaw TP)EI rasing method
(IVflG) 1664A Sts?=iIEM
m /1
Total Suspended
Solids
am I
pH
(Standard
Units}
6-9�
Total
Ashifall
in)i"(minutes)
Event
Duration
HAS YOUR FACILITY 1 -IAD -4 OR MORE BENCH MIARK ) XCEEi)ENCES
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES �] NV
NOVD
HAVE YOUCONTACTED-THEREGION? Y�� ❑
WHO AT THE REGION HAVE YOU SPOKEN WITH?
MAIL ORI GrINAE AND ONE COPY -OF THIS ANNUAL SUMMARY (INCLUDING ALL `6N® FLOW". "NO DISCHARGE" & LIMIT
VIOLATIONS) BY MARCH I OF EACH YEAR TO:
Division of Water,Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone],
YOU MAST SdCN TFdIS CERTIFICATION FO gANYINFORMATIDN IdF-PORTED.
"I certify, under penalty of law,,that this, document and all attachme►its 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. Eased on my inquiry, of the person or persons who manage tilt
system, or diose persons directly responsible for gathering the information, the information submitted is, to the best of my -knowledge and belief, tru6, aeccuk ode,
and complete. I aaaware that _there
� are significant -penalties -for submitting false information, including the possibility of fines'and imprisonment foe lwowirah
�7ttf f�C��l
(Signature of Pgfrmittee)
Permit Date: 1/.1/2010-12131/2014
(Date)
T,ast Revised 02-02-11
Cage 2 of 2