NCG030305_MONITORING INFO_20190326

STORMWATER DIVISION CODING SHEET
' NCG PERMITS
PERMIT NO.
DOC TYPE
❑HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑
YYYYMMDD

L I
Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and land Resources General Permit No. NCG030000
Date submitted 312kil l
CERTIFICATE OF COVERAGE NO. NCG03Q 1 5 SAMPLE COLLECTION YEAR 2014
FACILITY NAME f SAMPLE PERIOD ❑Jan -June ❑ Julyec�
COUNTY or ® Monthly' month
PERSON COLLECTING SAMPLES DISCHARGING TO CLASS ❑ORW ❑H rout ❑PNA
LABORATORY Lab'Cert.# ❑zero-flowA?§Ampply []SA
Comments on sample collection or analysis: [joOtherCg=K
own SECT ioN
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
Part A: Stormwater Benchmarks and Monitoring Results
No discharge this period?z
Outtall No.
:Date Sample.
Collected,
mo/dd/yr)
24-hour rainfall
amount,
inches'
Total Suspended,Solids.
pH,
Standard units
,Total Copper:
Total Lead
Total Zinc
Non -Polar O&G/
Total Petroleum
hydrocarbons
Total Toxic
Organi&
Benchmarks
_
-
100 mg/L"or 50 ing/O •
6.0 - 9.0
0.020 mg/L '.
0.075'mg/L
0.126,mg/L .
15 mg/L
' Trng/L
Parameter Code
-
'46529
C0530
00400
01119
01051
01094
.00552.
.78141
1 Monthly sampling (instead of semi-annual) must'begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z 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.
° See General Permit, Section B, Table 1 to.identify the especially sensitive receiving water classifications where the more -protective benchmark applies.
s Total Toxic Organics sampling is applicable only forthose facilities which perform -metal finishing operations, manufacture semiconductors, manufacture -
electronic crystals; or manufacture cathode ray tubes. For purposes of this.permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent'Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found In 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date:11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018
Page 2of3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management.plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of.the person or, persons directly responsible for managing compliance with the;permit monitoring requirement for total toxic organics
(70),1 certify that to the best of my knowledge and belief, no -dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. i further certify that this facility is €mplementing the all.the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
N A
Name (Print name)
Title ( rint title)
NIA
Signature Date
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 me1L". 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 Z or Tier 3 responses. see General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gall'of new oil per month.
D No discharge this period?'
Outfall'No.
Date'Sample Collected' `
(mo/dd/yr)
' 24-hour rainfall, amount,
Inches}
New Motor Oil or
HydraulirOil:Usage`-Petroleum�Hydrocarbons
Non -Polar 0&G/ Total
Total Suspended
Solids
Benchmarks
-
-
-
15 mg/L
100 mg/L or 50,mg/0 .
Parameter. Code
-
46S29
-NCOIL
0055Z
CO530
Footnotes from Part A also apply to Part B
Note If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier or Tier 3 responses. See General Permit text
Permit Date:11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018
Page 2 of 3

'wy
F09_PART A AND EA, T R MgNITORING 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 ANYONE OUTFALL? YES ❑ NO 0
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original cagy of thls DWI?, induding all "No Olschargg" reports, within 30 days of receiat of the lab results far at end of monitprjna 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
YO"UST 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 p%*le/for submitting false Info rmatlon, Including the possibility of fines and Imprisonment for.knowing violations."
Signature of Permittee
Permit Date.11/1/2018-05/31/2021
3ZHim -
Date
SWU-245, last revised 11/1/2018
Page 3 of 3

Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG030000
Date submitted 12 20 Ito
CERTIFICATE OF COVERAGE NO. NCG03 Q _Q 5 SAMPLE COLLECTION YEAR
FACILITY NAME i~cMVW+ -reiLAQLCQ IQ.S- I� �t ^r e.C4x3 Faskp e) SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
COUNTY_ 3!J- yJ!d _ �� RE r 1 LO pC^�+1 RG or [@Monthly: month
PERSON COLLECTING SAMPLES L Tool@,.. ING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORYt4l A Lab Cert. # JAN 0 2 2019 DZero-flow []WaterSupply []SA
Comments on sample collection or analysis: ®Other
6m otrTFFkL ill] hicaGm13M CENTRAL FILES
DWR SECTIONPLEASE REMEMBER TO SIGN ON PAGES 2 AND/DR 3 -�
Part A: Stormwater Benchmarks and Monitoring Results
[& No discharge this period?2
Outfall Na.
iJateSample
Collected'
(mo/dd/ r)
24-hourrainfal}
amount,
Inches
Total Suspended Solids
pH,
Standard units
Total Copper
Total Lead
Total Zinc
Non -Polar 0&G/Total•Toxic
Total Petroleum
Hydrocarbons
Organics
Benchmarks
_
-
100 mg/L or 50 mg/V
6.0 — 9.0
0.010 mg/L
0.075 mg/L
0.126 mg/L
15 mg/L
1 mg/L
Parameter Code
-
46529
C0530
00400
01119
01051
01094
OOS52
78241
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance forthe same parameter at the same outfall.
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
'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.
"See General Permit, Section B, Table 1 to identify the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date:11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018
Page 1 of 3

-�.
Facilities that incorporate a solvent management plan into the 5tormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall Include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my Inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), l certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan Included in the Stormw ter Pollution Prevention Plan."
Name (Print name)
��Qc G i` o 0 4-j-10 t• f
Title tt e
Signat a Date
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 ma/0 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 T7er 1, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
❑ No discharge this period?z
Outfall No.
Date Sample Collected'
(mo/dd/yr)
24-hour rainfall amount,
inch&
New Motor oil or
Hydraulic Oil Usage
Non -Polar o&G/ Total
Petroleum Hydrocarbons
Total Suspended
Solids
Benchmarks
-
-
15 mg/L
100 mg/L or 5o mg/O
Parameter Code
-
46529
NCOI L
00552
CO530
Footnotes from Part A also apply to:Part B
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: 11/1/2018-05/31/2021 SWU-245, last revised 11/1/201B
Page 2 of 3

P�
IF OR PAKT A AND -KART B M— QNITORIUG„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 ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an orlainal coot/ of this DMR, including all "No alsCharae" reports, _wthfn 30 days.of_retelpt of the lab results for at end of ►nonitorina 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 CERTIFIg00Ptfa ANY INFORMATION
"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 lr ctly responsible for gathering the Information, the Information submitted Is, to the best of my knowledge and belief, true, accurate, and complete. I
am awUe th4re aripAignificant penalties for submitting false information, Including the possibility of fines and imprisonment for knowing violations."
Permittee
Permit Date:11/1/2018-05/31/2021
12 -al g
Date
SWU-245, last revised 11/1/2018
Page 3of3

�;mnw• � �,
Stormwater Discharge Monitorin Re ort
for North Carolina DIVislon of Energy, Mineral and Land Resources General Permit No. NCG030000
bate submitted 91-7112
CEIRTiFICATE OF COVERAGE NO. NC603k9
FACILITY NAME Cmb2&_:Ze 0aies� LL.0 nle
COUNTY 6 ni
PERSON COLLECTIAG SAMPLES
LAB ORATORY;MZCLRftWktidae- .. Lab Cert:# 12
Comments on sampie collection or analysis:
Part A; Storrnvuater Benchrnarks and Monitoring Results
SAMPLE:COLLECTION YEARZP19,�
SAMPLE PERIOD Jan -June ❑ luly-Dec
or Monthlyl o t
DISCHARGING TO CLASS ❑ORW ❑H4W ❑Trout. . PNA
[]Zero -flour .[]Water Supply ❑sA
[]Other C
MAN ] 4 AWSE REMEMBER TO SIGN ON PAGES 2 ANC?/OR 3 �
O'V1 1. `ECI10N
I11;FOR?ATION PROCESSING U111 i No discharge this erlod?2
OutFall No.
Date Sample
Collected'
mo/dd/yr)'
24-hour rainfall
amount,
inchee
Total Suspended Solids
pH,
Standard units
Total Copper
Total Lead
Total Zinc
Non -Polar Q&G/Total
Total Petroleurn
Hydrocarbons
Toxic
0rganlc0
Benchmarks
_
-
100 mg/L or 50 mglV
6.0 — 9.0
0.010 mg/L
0.075 mg/L
0.126 mg/L
15 mg/L
1 mg/L
Parameter Code
45529
C0530
00400
01119
01051
01094-
00552
78141
/ O.2
N
0 021
NO.r,.
v+rbJ 141
L 13-
5MD
01005
ND
—
1 Monthly samplin&(instead of semi-annual). must begin with the second consecutive benchmark exceedance for the same parameter at the same outfali.
2For 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 maybe eligible for a.walver of the rain gauge,requlrement.
4 See General Permit, Section B, Table 1 to identify theespecially sensitive. receiving water classifications where the more, protective benchmark applies.
8 Total Toxic Organics sampling is applicable onlyfor those facilitieswhich perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics Is that definition contained In the EPA
Effluent Guidelines for the facility subject to the requirement.to sample (for metal finishing use the clef nitlon as found in 40 CFR 433.11; forsemiconductor
manufacture use the definition as found In 40 CFR 469,12; forelectronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date:11/1/2018-05/31/2021
SWU-245, last revised 11/1/2018
Page 1 of 3

+e'h
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requiremerit forTTO monitoring
maybe waived. The.solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certlflcatlon.statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requlrement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facillty Is implementingthe all.the provisions of the
solvent management plan included In the Stormwater Pollution Prevention Plan."
Name (Pri t name)
Title (Print title)
NIA
Signature Date
Note: Results must be reported In numerical format. Do not report Below Detection Limit, BOL, <PRL, Non -detect, IUD, or other similar non -numerical
format. When results are below the applicable;limlts, theytimust lie reported In the foEMat, "eXX ms/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 77er 1, ..Tier 2, or Tier 3 responses. See General Permit text
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil -per month.
❑ No.dlscharge this period?2
Outfail No.
Date Sample Collected'
(mo/dd/yr)
24-hour rainfall amount,
Inchess
New Motor Oil or
Hydraulic Oil:usage::
Non -Polar O&G/ Total
Petroleum Hydrocarbons
Total Suspended
Solids
Benchmarks
-
-
-
15 mg/L
100 mg/L or 50 mg/L•
Parameter Code
-
455Z8
NCOIL
00552
C0330
Footnotes from Part A also apply to Part B
lilote: If you report a sample value In excess of the benchmark, you must implement Tler.Z, Tier 2, or 77er 3 responses. See General.Permit text.
Permit Date:11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018
Page 2 of 3

F-09 FART A-ANA 288T B MONITORING R95ULTS:
• 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 11 SECTION 8.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUPFALL7 YES Q NO ❑
iF YES,.HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
ail an oriaf Ial copyof rhfsDMR, including ali "No Discharae reports. within 30 days of receipt of the tab results (or at end of-m—onitorinu period in the
case of'rNoVacharae" renorts)
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CER11FICATI0�,1 FOR ANY INFORMATION RE0�RTED:
"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 property gather and evaluate the information submitted. Based on my inquiry of.the person or persons who manage the system, or
those person"irectly responsible for gathering the: information, the information submitted is, to the best of my knowledge and belief, true, accurate, and. complete. I
am•awar� ha" re are significant penalties forsubmitting false information, including the possibility of fines and imprisonment for knowing violations."
Sig ature of Perrnittee Date
Permit slate. 11/1/201"S/31/2021 SWU-245, last revlsed 11%1/201B
Page 8 of 3