NCG140386 DMR SW (3)

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 0 3 8 6 SAMPLE COLLECTION YEAR: 2015
FACILITY NAME: Concrete Service Co. Plant No. 2 SAMPLING PERIOD: E] July -December January -June
PERSON COLLECTING SAMPLES Winnie Jenkins COUNTY Cumberland
CERTIFIED LABORATORY Pace Analytical Lab # 12 PHONE NO.( 910 ) 323-9198
Lab # ADD TO LISTSERVE? DYES X❑NO EMAIL:
OPTIONAL INFO: DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other C; NSW
Part A: Stormwater Monitoring Reauirements
Date Sample
Collected
Outfall No.
(mo/dd/yr OR
NO FLOW)1
pH
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total
4
Rainfall
(in)
In Tier 2
Monthly # of Months in Tier
2
Monitoring? 2 Sampling
n
(y/n)
- -
6-92
1002'3
-
-
- -
001 12/22/2015
7.6
61.2
960
1.38
No NA
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.
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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Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outfall
No.
pH
Date Sample
(Standard
Collected1 Units)
(mo/dd/yr)
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
(in) (gal/month) Monitoring? Sampling2
(y/n)
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO 0
HAVE YOU CONTACTED THE REGION? YES ❑ NO 0
REGIONAL OFFICE CONTACT NAME: Paul E. Rawls, Fayetteville Regional office
Mail Original and one coov 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: DWQ Central 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 thay7lualified p rsonnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those per�,ns dir ctl responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.amadupr at t ere are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of
(Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
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