NCG140124 - DMR SW

SSTOR ,'WATER DISCHARGE {•UTEALL (SDO) ual M" NITO 1NG FOR
GENERAL PERMIT NO. NCG14OIOO
i /,‘ SAMPLE COLLECTION YEAR: 42/9
cr:F TII•Il:slur OF'COVERAGE NO. N 14�,�_
FACILITY NAME: 79A! SAMPLING PERIOD: July-December (January-June
PERSON COLLECTING SAMPLES �c14/ f�? ; Q r_lf+/� COUNTYC' l- G4A/,G
CFit°'i'tI' EO LAf.;'ORATORY.- -„x'177 _--Lab# 2, PHONE NO. (70V )
Lab# ADD TO LISTSERVE? YES NO EMAIL: —
OPTIONAL INO"I, : _ DISCHARGING TO CLASS: I ISA [HQ.W I IPNA Trout I 'Other
Part A:Sicrmwater Monitoring Requirements _
Date Sample "---___� — -- In Tier 2
pH Event Total a Monthly #of Months in Tier
Collected TSS
Outfail No. (Standard Duration Rainfall
(mo/add/yr OR (mg/L) Monitoring? 2 Sampling
i Units) (minutes) (in)
INO /y� -�,
--- - . ELg1JV) (Yin) P E C E ►�(!rte"[...�
002,3
JAN 1 .0 2017
4/e w_—�_� _ f Y.0 CENTRAL FI
J ---_._—
_—____ — nWR SECTION
1 If"NO FLOW"or"NO DISCHARGE,Enter"NO PLOW"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'.anipiing shall he clone until 3 consecutive samples are below the benchmark or within the benchmark range
s TSS hPnclu nark values are 100 mg/I,except when discharging to ORW,HQW,Trout,and PNA waters where they are 50 mg/I.
''For each,,ample+]measurable storm event the total precipitation must be recorded using data from an on-site rain gauge.
mit DaLo. 7/1/2111•-60/30/2015 Last 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
Outfall Date Sample pH TPH using method' Total Suspended 'Event Total New Motor Oil #of Months
Monthly
No. Collected (Standard 1664A SGT-HEM Solids Duration Rainfall4 Usage in Tier 2
Units) (mg/L) (mg/L) (minutes) (in) (gal/month) Monitoring? Sampling2
(mo/dd/yr)1
6-92 152 _ 1002'3 - - — - -
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL(INCLUDING VEHICLE MAINTENANCE)? YES ❑NO❑
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 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 a are that there are significant penaltiese�for submitting false information,including the possibility of fines and imprisonment for knowing violations."
, �/� �'/1 l� /",3-x0/7
(Signature of Permittee) (Date)
Permit Date:7/1/2011-60/30/2015 Last Revised 7/13/11
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