NCG030619 DMR SW (3)

4 '
Semi-annual Stormwater Di:,charge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
_ i Date submitted ��l.�-► �� i to
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CERTIFICATE OF C9ERAGE NO. NCG03' ;0 f -i SAMPLE COLLECTION YEAR 2014
FACILITY NAME ¢Ce IMA h Te Gl,v-.1 o/051. ' s SAMPLE PERIOD Jan-June ❑July-Dec
COUNTY M p c-fc.-(2 v, b;1�r or Monthly (month)
PERSON COLLECTING SAMPLES' kei-i yYvtie-hn DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY t er 7e cG, Lab Cert.# Sb ❑Z ro-flow ['Water Supply OSA
Cornvents on sample c Ilectign or analysis: V Other
Kepori- irec_W 1 9 I ai//14)& 614fel 6/(0frik)
REcEi
Vrt°ASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 ->
JUN 2 7 Z016
Part A:Stormwater Benchmarks and Monitoring Results
CENTRAL RAL FPLE5 III No discharge this period?2
sCC00—N
Date Sample 24-hour rainfall pH, Non-Polar 0&G/
Outfall No. Total Suspended Solids Copper Lead Zinc Total Petroleum Total Toxic
Collected' amount, Standard units Organicss
(mo/dd/yr) Inches3 Hydrocarbons
Benchmarks===> _ - 100 mg/L or 50 mg/L4 6.0—9.0 0.007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L
,51/q,/©/ 72 7. i 0 005 01 4 ©irk
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall,you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on-site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit,Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors,manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement toysample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12;for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
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Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
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114 ' Facilities tll, incorporate a solvent management plan into the Stormwater Poi, _,on Prevention Plan may so certify, and the requirement for TTO n._ ,itoring
may be waived. The solvent management plan shall include a list of the total toxic organic'compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver,the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(ITO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
20A) Ct - s
Name(Print name)
TIL-A iAT VrC 2
Title(Print title)
glnetcW 166----- -
(Signature) (D e)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL,<PQL, Non-detect, ND,or other similar non-numerical
format. When results are below the applicable limits,they must be reported in the format, "<XX mg/L",where XX is the numerical value of the detection
limit, reporting limit,etc. in mg/L. -
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier Z or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging>55 gal of new oil per month.
TI No discharge this period?2
Outfall No. Date Sample 24-hour rainfall
Collected) amount, Non-polar O&G/TPH by
_ (mo/dd/yr) Inches3 EPA 1664(SGT-HEM) Total Suspended Solids pH
Benchmarks===> _ - 15 mg/L 100 mg/L or 50 mg/L* 6.0-9.0 SU
11\iM
Footnotes from Part A also apply to this Part B
*See General Permit text,Table 5,identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245,last revised 10/25/2012
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'Note: If ya, sport a sample value in excess of the benchmark, you must imp►. .ent 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 IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SEC ON B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCE R THE SAME PARAMETER AT ANY ONE OUTFALL? YES U NO❑
IF YES,HAVE YOU CONTACTED T1 �DWQ EG NAL OFFICE? YES NO
REGIONAL OFFICE CONTACT NAME: - C./1,a 1640a.C.49Cz
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 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 penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations."
R-4/)1W e/2-09/&
(Signature of Permittee) (Date)
Permit Date:11/1/2012-10/31/2017 SWU-245,last revised 10/25/2012
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