SW Discharge Monitoring Report

Quarterly Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG240000
Date submitted 7 -1 -IV
CERTIFICATE OF COVERAGE NO. NCG24 O O co
FACILITYNAME MGS1,1Z FA c, L, A/
COUNTY CAA7-HAr'9
PERSON COLLECTING SAMPLES STEVE C o cA
LABORATORY PACE Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitorine Results
SAMPLE COLLECTION YEAR 2- g ` L
SAMPLE QUARTER ❑ Jan -March April -June ❑ July -sept ❑ Oct -Dec
or ❑ Monthly (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water supply RSA
[Other W -</ U
Tntn1 pvpnt rninfrrll 2 /- • l — n Ai- i.:
r N ����s �����«du �� yudrirrry� rnus[ oegm wain
Z the second consecutive benchmark exceedance for the same parameter at the same outfall.
The 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.
s For sampling periods with no discharge, you must still submit this discharge monitoring report with a checkmark here.
°The TSS benchmark value is 100 mg/L; except when discharging to ORW, HQW, Trout, and PNA waters in which case the benchmark is 50 mg/L.
Permit Date: 10/1/2011-9/30/2016 Last Revised 12/02/11
Page 1 of 2
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r N ����s �����«du �� yudrirrry� rnus[ oegm wain
Z the second consecutive benchmark exceedance for the same parameter at the same outfall.
The 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.
s For sampling periods with no discharge, you must still submit this discharge monitoring report with a checkmark here.
°The TSS benchmark value is 100 mg/L; except when discharging to ORW, HQW, Trout, and PNA waters in which case the benchmark is 50 mg/L.
Permit Date: 10/1/2011-9/30/2016 Last Revised 12/02/11
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Date Sample
collected'
1 (rno/dd/Yr)
Outfall No.
pH TPH using method
16644 SGT -HOW
Total Flow
T Raintall' This Average New Motor Oil Usage
Period'
loonW
i
Footnotes from Part A also apply to this Part B
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES INA 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 []NOR
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one coov of this DMR. includina all "No Discharae" reports, within 30 days of receipt of the lab results (or at end of monitoring period
in the case of "No Discharae" 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."
(Signature of Permittee)
Permit Date: 10/1/2011-9/30/2016
7—
(Date)
Last Revised 12/02/11
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