NCG080190 DMR SW

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted 10/23/2015
CERTIFICATE OF COVERAGE NO. FCG080i9-0 - SAMPLE COLLECTION YEAR 2015
FACILITY NAME United Parcel Service-Statesville SAMPLE PERIOD[]Jan-June []July-Dec
COUNTY Iredell or nMonthly1 (month)
PERSON COLLECTING SAMPLES Ryan R.Osborne(INENCO,INC.) DISCHARGING TO CLASS []ORW nHQW []Trout nPNA
RECE
LABORATORY Pace Analytical Services,Inc. Lab Cert.# 12,40,37706,&3773 IV D []Zero-flow PIWater Supply PISA
LABORATORY INENCO, Inc. Lab Cert.# 5540 OCT 2 8 2015
Comments on sample collection or analysis: []Other Class C
CENTRAL FILES
DMR SECTSSE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? X yes — no
Part A:Vehicle Maintenance Areas Monitoring Requirements(If applicable) n No discharge this period?2
Outfall Date 00530 00400 00556
No. Sample Collected, Total Suspended pH, Non-Polar Oil and Grease/TPH EPA New Motor Oil Usage,
mo/dd/yr Solids,mg/I Standard units Method 1664(SGT-HEM),mg/L Annual average gal/mo
Benchmark - 50 or 100 see permit Within 6.0–9.0 15 -
SDO-001 04/25/2015 3.2 6.22 <5.0 63
51)0-002 04/25/2015 10 7.08 <5.0 63
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals(if applicable)
Outfall Date 00556 00530 00400
No.' Sample Collected, Non-Polar Oil and Grease/TPH EPA Method Total Suspended Solids pH,
mo/dd/yr 1664(SGT-HEM),mg/L mg/I Standard units
Permit Limit - 15 50 or 100 see permit Within 6.0–9.0
1 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
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STORM EVENT CHARACTERISTICS:
Date 04/25/2015 to 04/26/2015 (first event sampled)
Total Event Precipitation(inches): 0.17
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 PARTAAND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A 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 ANY ONE OUTFALL? YES NO X
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 of 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 276994617
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,t -in"ormation submitted is,to the best of my knowledge and belief,true,accurate,and complete I am aware that
there are significant penalties for submit g false fo ation,including the possibility of fines and imprisonment for knowing violations."
/c / /5
(Signature of Permittee) (Date)
Additional copies of this form le downloaded at• http://portal.ncdenr.org/web/wg/ws/su/npdessw#tab-4
SWU-250 last revised April 11,2013
Page 2 of 2