NCG140008 - DMR SW

STORMWATER DISCHARGE OUTFALL (SDO) - Semi-Annual MONITORING FORM -
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO..NGG!141'Wa} 20140•,
SAMPLE COLLECTION YEAR: �®� RECEIVED
FACILITY NAME: 2ec 1A _COACtiJCo• t4sif #32 SAMPLING PERIOD: N1uly-December ❑January-JurIEC 2 8 2016
PERSON COLLECTING SAMPLES Wte_ O ►a^ COUNTY L..ehoi r CENTRAL FILES
CERTIFIED LABORATORY Ehvo f rtme4t4- I hit.Lab# /0 PHONE NO. (2.Q) z'7-900e !SWR SECTION
Lab# ADD TO LISTSERVE?OYES I INO EMAIL:
OPTIONAL INFO: DISCHARGING TO CLASS: OSA ❑HQW ❑PNA ❑Trout ❑Other
Part A:Stormwater Monitoring Requirements
Date Sample In Tier 2
pH Event Total
Collected TSSa Monthly #of Months in Tier
Outfall No. (Standard Duration Rainfall 2
(mo/dd/yr OR (mg/L) Monitoring? 2 Sampling
Units) (minutes) (in)
NO FLOW)1 (Yin)
- - 6-92 1002'3 - - - -
I 12,42-/L, loaf L�s Z 6� 1�3 Al ��A
2, t2 i2 ►to G1 7 ® X11
1 If"NO FLOW"or"NO DISCHARGE,Enter"NO FLOW"or"NO DISCHARGE"for each outfall here. Please make sure to mark the sample period above.
2 If a value is in excess of the benchmark,or outside the benchmark range(for pH),you must implement the Tier 1 or Tier 2 responses in the General Permit.Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range. ,
3 TSS benchmark values are 100 mg/I,except when discharging to ORW,HQW,Trout,and PNA waters where they are 50 mg/I)
a For each sampled measurable storm event the total precipitation must be recorded using data from an on-site rain gauge.
11, Permit Date:7/1/2011-60/30/2015Last Revised 7/13/11
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Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using>55 gal of new motor oil/month—averaged over a calendar year.
In Tier 2
pH TPH using method Total Suspended Event Total New Motor Oil #of Months
Outfall Date Samplea Monthly
(Standard 1664A SGT-HEM Solids Duration Rainfall Usage in Tier 2
No. Collected Units) (mg/L) (mg/L) (minutes) (in) (gal/month) Monitoring? Sampling2
(mo/dd/yr)1 (Y/n)
6-92 152 1002'3 - - - - _
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL(INCLUDING VEHICLE MAINTENANCE)? YES El NO El
HAVE YOU CONTACTED THE REGION? YES ❑ NO❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this DMR(including all"No Flow"&"No Discharge" reports)within 30 days of receipt of sample(or at end of monitoring period
in case of"No Flow")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 qualify-. personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system,or
those person di,' 'y responsible for gathering the information,the information submitted is,to the best of my knowledge and belief,true,accurate,and complete. I
am : �are tha ,;I - e are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations."
/2,22.20/(,
(Si:na ure of 31r ittee) (Date)
111) Permit Date:7/1/2011-60/30/2015 Last Revised 7/13/11
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IEWk©IENER 1lp hC©TparmNd
Drinking Water ID: -37715...
Wastewater ID: 10
PO. BOX 7085, 114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N C. 27835_7085 FAX [phone]
ID#: 1098
READY MIX CONCRETE (KINSTON)
MR. MIKE ODOM
1020 E. 5TH STREET DATE COLLECTED: 12/12/16
WASHINGTON ,NC 27889 DATE REPORTED : 12/15/16
REVIEWED
Stormwater Stormwater Analysis Method
PARAMETERS (#1, Grab) (#2, Grab) Date Analyst Code
PH (not to be used for reporting) 6.8 6.7 12/13/16 KKM 4500HB-00
Total Suspended Residue, mg/I 3.7 <2.5 12/14/16 MAR 2540D-97