NCG020580 DMR SW (2)

II ANNUAL SUMMARY DMR - STORMWATER II
SEND TO CENTRAL OFFICE*
STORMWA TER DISCHARGE OUTFALLS (SDO)
GENERAL PERMIT NO. NCG020000
'Report ALL STOIUMI11ATER Momtonng Data on this form (including No Flow and No Discharge and Permit Lunit Violations) by MARCH 1 of each year
CERTIFICATE OF COVERAGE NO. NCG020580 SAMPLE COLLECTION YEAR: 2015
FACILITY NAME: Richmond Quarry COUNTY: Richmond
PERSON COLLECTING SAMPLES: N/A PHONE NO. [phone]
CERTIFIED LABORATORY: PACE ANALYTICAL Lab #12 ADD TO LISTERVE? YES ❑ NO ❑ EMAIL:
Part A• Stormwater Monitoring Requirements
Date Sample
Outfall Collected
No. (mo/dd/yr OR
NO FLOW)'
In Tier 2
Monthly
Monitoring?
y/n)
# of Months in Total Flow
Tier 2 (MG)
Sampling
Total Suspended Total Event
Solids Turbidity4 Settleable Rainfall Duration
(mg/1) (NTU) Solids (ml/1) to
- -
-
- -
1003,4 See Footnote 3,4 0.1 3
No SW Outfalls Exist on Site
Richmond Quarry is an undeveloped greensite
ilf "NO FLOW" or "NO DISCHARGE," enter "NO FLOW" of "NO DISCHARGE" for each outfall here and the Date Range
2Pei NCG02 Tier 2 Monthly Sampling shall be done until 3 consecutive samples aie below the benchmaik of within the benchmaik range
31f a value is in excess of the benchmark, or outside the benchmark range (foi pH), you must implement the Teir 1 of Tiei 2 responses in the General Permit
4TSS benchmark values aie 100 mg/l except in ORW, HWQ, tiout, and PNA waters where they are 50 mg/1
5The discharge shall not cause an instantaneous measurement of the turbidity of the receiving water to exceed 10 NTU for freshwater streams, lakes, and ieservois designated
as trout waters, 25 NTU for all lakes and ieservois, and all salt water, 50 NTU for all other streams and surface waters Tuibidity maybe monitored at the SDO
Alternatively, the permittee may choose to monitor turbidity in the receiving water, duectly upstream and downstream of the SDO.
Permit Date l/1/2010-12/31/2014 Last Revised 01-21-11
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Part A• Vehicle Maintenance Activity Monitoring Requirements for facilities using> 55 gal of new motor oil/month on average
Outfall
No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in New Motor
Tier 2 Oil Usage
Sampling (gal/month)
Total Flow TPH using method
(MG) 1664A SCT -HEM
(mg/1)
Total Suspended
Solids
(mg/1)
pH Total Event
(Standard Rainfall Duration
Units) (in)
- - 153 1003
6-93
N/A
0
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑
HAVE YOU CONTACTED THE REGION?
WHO AT THE REGION HAVE YOU SPOKEN WITH?
YES ❑ NO ❑
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO 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]
YO U 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. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisionment for knowing
violations."
2�
2/15/16
(Signature Permittee) t (Date)
Perinit Date 1/1/2010-12/31/2014 Last Revised 01-21-11
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