NCG090031 DMR SW (2)

Semi-annual Stormwater Discnarge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG090000
Nc&-oq Dos Date submitted y/p21/6
V `
CERTIFICATE OF COVERAGE NO. NCG09,0_, SAMPLE COLLECTION YEAR
FACILITY NAME Si 3 5- Giwv r-UrUN6 LLG SAMPLE PERIOD ®Jan-June ❑July-Dec
COUNTY e Crm o11/i) 0 1 {.month)
PERSON COLLECTING SAMPLES Krems DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY /`I r ce?t5!4 G Lab Cert.# RECEIVED OZero-flow ['Water Supply OSA
Comments on sample collection or analysis:
Other (°, -& ,5 C
651/4,
6)..a JUL 2 5 2016
PLEASE REMEMBER TO SIGN ON THE REVERSE
CENTRAL FILES
DWR SECTION
Part A:Stormwater Benchmarks and Monitoring Results
❑ No discharge this period?2
Date Sample 24-hour rainfall
Outfall No. 1
Collected amount,
(mo/dd/yr) Inches3 Total Cadmium Total Chromium Total Lead
Benchmarks===> - - 0.001 mg/L 1.0 mg/L 0.03 mg/L
5bo 6/3//s" /,t' `'0.00 / 4a0C9 / �0. Do 3
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.
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 2, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2012-10/31/2017 SWU-255,last revised 10/25/2012
Page 1 of 2

Part B: % -, le Maintenance Area Monitoring Results: only for facilities averaging> 55 gal of new oil per month.
❑ No discharge this period?2
Date Sample 24-hour rainfall
Outfall No. 1
Collected amount, Non-polar O&G/TPH by Total Suspend i s pH
(mo/dd/yr) Inc-Fres EPA 1664(SGT-HEM)
Benchmarks=__> - / - 15 mg/L 1OO—mg/L or 50 mg/L* 6.0—9.0 SU
i / -
77
/V
/
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.
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 AAND 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
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 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."
e;t---
o./(, e 71611C
(Signature of Permittee) (Date)
Permit Date:11/1/2012-10/31/2017 SWU-255,last revised 10/25/2012
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR) /SPPP Annual Update DATA REVIEW FORM
Calendar Year" ` 5
Individual NPDES Permit No. NCS❑n❑n ❑ or 3 (
Certificate of Coverage (COC) No. NCG�'7 I�I®❑d ❑p® Ni CLO q
o
This monitoring report summary of the calendar year should be kept on file on-site with the facility SPPP.
Facility Name: it 3 04 (),?= -a)itZ(et!c / LLC
County: /24 G( cam,P
Phone Number: (t)C ) -Y c S77? Total no. of SDOs monitored r(
Outfall No. S f)0--4
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No IZ
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No E
If this outfall was in Tier 2 last year,why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No a
Parameter, (units)
Total 1-bf44--
Rainfall, 01-0 H C#26/1/ L —v>
inches 0,10- 177,9/1-
Benchmark
77,9/L,.Benchmark . N/A' 6, 0o1.... U
Date Sample
Collected,
mm/dd/yy
(36/a /i=,' 1, " 40 , 002 40,ova_ 4-6,0003
Zl191//S- t C71)d 40,001 4.0,(7o03 _
SWU-264-Generic Annual DM R
Last revised 5/17/2013

"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."
Signature / CD)2(Da2/, A/5 bifi67�b�
Date n ,z " 2_6/6
For questions, contact your local Regional Office:
DWQ Regional Office Contact Information:
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Wil jington
ASHEVILLE REGIONAL OFFICE FAYETTEVILLE REGIONAL OFFICE MOORESVILLE REGIONAL OFFICE
2090 US Highway 70 225 Green Street 610 East Center Avenue/Suite 301
Swannanoa,NC 28778 Systel Building Suite 714 Mooresville,NC 28115
[phone] Fayetteville,NC 28301-5043 [phone]
[phone]
RALEIGH REGIONAL OFFICE WASHINGTON REGIONAL OFFICE WILMINGTON REGIONAL OFFICE
3800 Barrett Drive 943 Washington Square Mall 127 Cardinal Drive Extension
Raleigh,NC 27609 Washington,NC 27889 Wilmington,NC 28405-2845
[phone] [phone] [phone]
WINSTON-SALEM REGIONAL OFFICE CENTRAL OFFICE
585 Waughtown Street 1617 Mail Service Center , 'To preserve.protect
Winston-Salem,NC 27107 Raleigh,NC 27699-1617 and enhance
[phone] [phone]Aionh Cardona's water_ "
SWU-264-Generic Annual DMR
Last revised 5/17/2013