NCG080142 DMR SW (3)

01 Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted 2/13/15
CERTIFICATE OF COVERAGE NO. ING a `8'0 - SAMPLE COLLECTIONQYEAt ,0T- G K
FACILITY NAME A.T. Williams Oil Company University Parkway SAMPLE PERIOD x Jan -June July -Dec
COUNTY Forsyth or Monthly (month)
PERSON COLLECTING SAMPLES Lynne Hays 'RECEIVEPISCHARGING TO CLASS ❑ORW ❑HQW [:]Trout❑PNA
LABORATORY R & A Lab Cert. # 34 Comments on sample collection or ❑Zero -flow ❑Water Supply [:]SA
analysis: FEB 16 2315 Other C
CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4
DWR SECTION
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _x- yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
❑ No discharge this periods
Outfall-" Date,"00530
Sample Collected,'
�mo/dd/yr
'
00400
0055Ei�
•
Tofal Suspended,
Solid; mg/L, "' ,
�pH; _ = -
-Standard, units,,-
= Non -Polar Oil and Grease/TPH-EPA
Method 1664 (SGl'=HEM), mg/.L
'-New Motor Oil Usage,
;Annual average gal/mo
Benchnia�rk`
15 _
.Within 6.0:- 9:0:
6.0 _ 9.0 `
SDO #1 1/23/15
38.4
7.8
6.10
>55
SDO #2 1/23/15
40.0
7.6
<5.0
>55
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No:
Date
Sample Collected,t�
rico/dd/yr- .
00556 =
00530'= _
00400
No Oil an re EPA MethodF
_ 1664 (SGT-HEMj"mg/L ��
Total Suspended Solids,
�'mg/L'�.�:
Standard units
-Permit Limit, '
-
15 _
50 or 100 see, permit
6.0 _ 9.0 `
I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Page 1 of 2

STORM EVENT CHARACTERISTICS:
9
Date: 01/23/15 (first event sampled)
Total Event Precipitation (inches): .46
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES INA ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt ar the lab results (or at end of monitoring period in
the case of "No Discharge" reports) 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
that qualified personnel properly gather and evaluate the information submitted. 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 penallttiies for submitting false information, including the possibility of fines and imprisonment for knowing violations." -
i 1-i0—
Lynne Hays for A.T. Williams Oil Company 02/13/15
(Signature of Permittee) (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-250 last revised April 11, 2013
Page 2of2