NCG140423 - DMR SW (2)

(
ST©RMWaTER ©fiSCHARGE OUTFALL POO)) - 140006GENERAL PERMIT 6��9t.e ( MC
e.. SAMPLE COLLECTION YEAR:
�:
CERTIFICATE OF COVERAGE fI O.',I106146 r` � , SAMPLING PERIOD: December OJanuary�-Juroe
FACRILITY NAME: ,{� v '9 I ' - COUNTY___:=01;24.-------
PERSON COLLECTING SAM LES mkt ` Lab#�
COUNTY
N®.(3 L ) f 1�cj.Q�
CERTIFIED LAI30I>AYOR�f Lab a ADD TO LISTSERVE?DYES ONO EMAIL:�
DISCHARGING TO CLASS: OSA [ Q ❑
PNA []TroaJt O63er
OPTIONAL INF r: 0—)
Part A:Storonwa ter Monitoring Requirements in Tier 2
Date Sample Event Total TierMont2 #of Months in Tier
pR TSS E2ainfall4 a 2 Sampling2
Collected (Standard Duration Monitoring.
Outfall No. (rrao/dd/yr o6t Units) (mg/L) (minutes) (in) (19/n)NO FLOW)1 2 1002,3 -
11111111111111111111111111111111
IIIIIIIINIIIIIIIIIIINIIIIIIIIIIIIIIMIIIIIIIIIIIIIIIIINIIINIIJAN 0 2017
_. IIIIINIIIIIIIIE111111111111111
D
1111111111111 IIIIIIIIIII
1111111111111111111 IIININIIII 11111111111111111111111111111
11111111111111 1111111111111 1111111111111 illIllIllMNNIIIIIIII
IIIIIIIIIIIIIMIIIIIIIIIIIIMIIINI 111111111111111 11111111111110111111111111111
111111111111111111.111111111.1111111111111.111111111111 1111111.1111
INIINIIIIIIIIIIIIIIIIIIIIIIIIIIMIIIIIIIIIIIIIMIINIIIIIIII
■1111111111111 111111111111
INIIIIIIIIIINIIIIIIIII Please make sure to mark the sample period above.
youMEN IIMIIIII
must implement the Tier 1 Tier a2 responses e the General Permit.Tier 2
1 If"NO FLOW'or"NO DISCHARGE,Enter"NO FLOW"or"NO DISCHARGE"for each outfall here.
2 If a value is In excess of the benchmark,or outside the benchmark range(for pH), rang
Monthly sampling shall be clone until 3 consecutive samples are below the be
ncTroma k ornd within
NA inwthesbenche mark
are e. mg/I.
3 TSS benchmark values are 100 mg/I,except when discharging to ORW,
HQW,4 For each sampled measurable storm event the total precipitation must be recorded using data from an on-site rain gauge. Last Revised 7/13/11
Page 1 of 2
permit Date:7/1/2011-60/30/2015

. ` new motor oil/month—averaged over a calendar year.
� >55 gal of
Monitoring Requirements for facilities ussngin Tier 2 ®f Months
Part�: �Pehicle Maintenance Activity M Event Total New flPiotor Oil Monthly in Tier 2
Total Suspended Rainfall° Usage BUB®raitorirog? SarZ
p� T/5 using4Amethod SGT-HEM Solids Duration (gal/month) Monthly
(Standard
(ino/cidiyr)1 Win)
$�64A minutes) (in)
®aitfall Date Sample (standard Qmg/L) (
No. Collected si9o�its) (mg/L)
6-92
IIIIIIIIIIIIIIIIIIIIIMIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIINIIIIIIHIIIIIIIIIIINIIIIIII
11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
IIIIIIIIIIIIIIIIIIMIIIIIIIIIIIIIIIIIIIIIIIIIMNIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIINIIIIIIIII
IIIIIIIIIIIIMIIIIIIININIIIIIIIIIIIIIIIIIIIIIIIIIIIMIIMIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIMIIIIIIIIIMINIIIIIII
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIINIIIIIIIIIMIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII.MIIIIIIII"
IINIIIIINIMIIIIIOIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIINIIIIIIMIIIIIIIIIIIII MUM
••III' IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIMIIIIMINIIIIIIIIIIIIIIIIIIIIINIIIIIIIIIIIIIIII
offi,r �..• ....
_ E? YES ❑NO
HAVE YOU CONTACTED THE
BENCHMARK EXCEEDS ES AT ANY ONE OUTFALL(INCLUDING VEHICLE MAINTENANCE)HAS YOUR FACILITY HAD 4 OR E OORNE BEN YES ❑N
sle or at end of monitorin: ,eriod
REGIONAL OFFICE CONTACT NAME:
Mail Orisinal and one co+ of this DMR to
cludin: all"No Flow" &"No Dischar:e" resorts within 30 da s of receist of sam
in case of"No Flow" to:
Division of Water Quality
Attn:DWQ Central Files
1617 Mail Service Center
Raleigh,North Carolina 27699-1617 stem designed to
direction or supervision in accordance with a system a the system,or
Y
ANY under my ed on my inquiry of the person or persons who rnanag
MUST e enB5 y of laFO that ! INFORMATION antMA Rt �e: Y accurate,and edto complete. I
"Icertify,sunder penalty s nn l that this gaerdocument and all attachmentshwere prepared the person or p persons
who,manage
qualifiedc personnel s p n s responsible
for
gathering and evaluateorion,e snformation submitted.the information submitted is,to the best of my dand
for knowing
assure that the possibility of fines and imprisonment
those persons directly responsible fo for submitting false information,including /� ` f
am aw• - hat then s significant penalties
(Date)
Last Revised 7/13/11
. �ataare of gn6$tee) Page 2 of 2
• r
Permit Date:7/1/2011-60/30/2015

-;
._
i TOTAL PRECIPITATION Facility Name: tor ) .41 Rech nli 1
,.
DAILY LOG - YEAR: 20 1Le Location: 1 b O /A-M o Ls 6 n Lai-
- Ruud i i \)L2-764i.
Directions: Enter on-site daily rainfall amounts in inches.
I Jan I Feb I Mar I Apr I May I Jun I Jul I Aug I Sep I Oct I Nov I Dec
1 p' ,e3:--5 ok t3 0 ,ct i 07
, 2 730c/ ,01544-- / 78 . ,.74 0 iE5 0 0 - 0 (23
i 3 (3 I. ,1 , 6 Ca 8er * ...________, .•
3 t., i i 0
4 0 rb e es munne5 - , er
; 5 er. IIIMMIEBIMIllallillatIMIM 0- 11M1
07g 11111111SIMIMarl 0-
7 IM -- 1-- a/ . 2 IMIliralMilliMIIMMI (Or
8 MUM MI= -7Of
9 NXIIIMMINI 7 . 2, , .cl
10 4? . e. INVIII er- MI
11 IMIllaraillatall ,_1111111.1W
12 in,..._1121111111111PAIIM W 0- ,ii- f _PC .0 1
13 gralirMVE i 0 - 0 ..) ,er di
14 tailiningli= 6 Or -1111111.1111115111r°
15 11§1111111111111141 0 , 07 -6 -C' Cli) 0. -• •
16
17 c,,=; )0-- - 0 SS APky 15 0 S5 -05- )6'''
18 g' Ca' ef
19 e -6 I 9 0- IMIlliallilln. _ .0 Ira IMI
20 ,02 e1 oq _or- /6?,,q -- 11 ,e5- =
21 25 .02 P, 41. i - ( '15- I' • 0- er M II.
22 1..L"3 .:OR . 0 3 / /q fr." „6--- , . , , 0- ., -- i-M1
23 Licfi ijr . 03 , 0 Pf-
24 0 . -Li 0 / ..r 25")r 4 — 0 6.0g=
25 1141111111114111=1111=1
26 0 g OG 0 11111111MIAMIMEIM er -, )--
27 . 01 r. 453 .iLi a ,i) q5(? .)2._ 16] „er O'• _ .--
28 -6:3--- a'. 01 2 , ggea:-
29 ., O e 0,- 0, -
30 ,,er k . 0 1
L 31 0' !61'9 0 Aex --M
Form#5