NCG080720_MONITORING INFO_20181123

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V
DOC TYPE
❑HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ � b I 1l l)-3
YYYYMMDD

•
North Carolina Division of Energy, Mineral, and Land Resources
SEMI-ANNUAL STORMWATER OUTFALL DISCHARGE MONITORING REPORT (DMR)
Vehicle Maintenance Ictivities Only
Date submitted CERTIFICATE OF COVERAGE NO. NCG d J 7 2 o d S PLE COLLECTION YEAR dmei9lQp
FACILITY NAME _ `e'11Z AVAA/ -- RECEIVE
COUNTY DEC 05 2018
PERSON COLLECTING SAMPLES PLEASE REMEMBER TO SIGN ON THE REVERSE
LABORATORY Cert. CENTRAL FILES
DWR SECTiCh:
Vehicle Maintenance Activity (VMA) Stormwater Monitoring Results: Only for facilities using an average of > Ss gal of new motor oil per month.
Total event rainfall 1 - ✓ or ❑ No discharge this period'
Outfall No.
Sample
Collected,
mm/dd/yr
Total Suspended
Solids (TSS), mg/L
Non -polar O&G/TPH, mg/L
(Method 1664 SGT-HEM)
(if applicable)
Oil and Grease, mg/L
(if applicable)
pH, Standard units
(if applicable)
New Motor Oil Usage,
Annual average gal/mo
Benchmarks
-
100 or 50
is
30
Within 6.0 — 9.0
-
O
io /�
/8
C.S.o
6•3/
1719
0 .Z
/o /o /2
O
•,7
/J0
D
o .o /8
S. o
G •
170
ow
I iv "o /If
< S D
4.9s
170
1 The total precipitation must be recorded using data from an on -site rain gauge.
2 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
3See General Permit text that identifies the especially sensitive receiving water classifications where the more protective TSS benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or any other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the
laboratory's 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 1, or tier 3 responses. See General Permit text.
FOR MONITORING RESULTS:
• A single benchmark exceedance triggers TIER 1 REQUIREMENTS. See permit PART II SECTION B or C.
• Two exceedances in a row for the same parameter at the same outfall trigger TIER 2 REQUIREMENTS.
* TIER 3: Has your facility had four or more benchmark exceedances for the same parameter at anyone outfall? YES ❑ NO ❑
IF YES: Have you contacted the DEMLR Regional Office? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
SWU-254 Vehicle Maintenance Activities DMR Last Revised August 11, 2014
Page I of 2

Mail an original and one copy of this DMR including all "No Discharge" reports, within 30 days of receipt of the lab results tor at end o
monitoring period in the case of "No Discharge" reports) to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 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,_ar d 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
,v .Z
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/irLopdes-stormwater
SWU-25ehicle Maintenance Activities DMR Last Revised. August II. 2014
10 0 'r2 o f 2

North Carolina Division of Energy, Mineral, and Land Resources
SEMI-ANNUAL STORMWATER OUTFALL DISCHARGE MONITORING REPORT (DMR)
Vehicle Maintenance Anti i ies Only
Date submitted II G /7
CERTIFICATE OF COVERAGE NO. NCG__0 Q Q 2 ;Z 0 SAMPLE COLLECTION YEAR LI
FACILITY NAME 44W C w.W✓tea!✓.l V ZZ7::;! dip RECEIVED
ECEJVED
COUNTY /fltet�f'Lk/�sC�_
PERSON COLLECTING SAMPLESY dr—We dl . NOV 16 LU11 PLEASE REMEMBER TO SIGN ON THE REVERSE �
LABORATORY_ per= Lab Cert. # yo.2- CENTRAL RAI_ FILES
Vehicle Maintenance Activity (VMA) Stormwater Monitoring Results: Only 9?ae fff4!V Ong an average of > SS gal of new motor oil per month.
Total event rainfall'. or ❑ No discharge this period
Outfall No.
Sample
Collected,
mni/dd/yr
Total Suspended
Solids (TSS), mg/L
Non -polar o&G/TPH, mg/L
(Method 1664 SGT-HEM)
(if applicable)
Oil and Grease, mg/L
(if applicable)
pH, Standard units
(if applicable)
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
100 or 50
n
30
Within 6.0 — 9.0
-
o I� /
C
�
/o ` i
C So L
•dam
3
/ot 77.2
L S-a
G
o ,
' The total precipitation must be recorded using data from an on -site rain gauge.
For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
3See General Permit text that identifies the especially sensitive receiving water classifications where the more protective TSS benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or any other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the
laboratory's detection limit, reporting limit, etc. in mg/L.
Note: if you report a sample value in excess of the benchmark, you must implement Ter 1, Tier 2, or I"er 3 responses. See General Permit text.
FOR MONITORING RESULTS:
• A single benchmark exceedance triggers TIER 1 REQUIREMENTS. See permit PART II SECTION B or C.
• Two exceedances in a row for the same parameter at the same outfall trigger TIER 2 REQUIREMENTS.
• TIER 3: Has your facility had four or more benchmark exceedances for the same parameter at any one outfall? YES ❑ NO ❑
IF YES: Have you contacted the DEMLR Regional Office? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
SW-254 Vehicle Maintenance Activities DMR Last Revised- August]], 2014
Page I of 2

Mail an original and one copy of this DMR, including all "No Discharge"" reports, within 30 days of receipt of the lab results (or at end of
monitoring period in the case of "No Discharge" reports #a:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 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."
///,I/1,�
(D e)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.ore/web/ir/npdes-starmwater
C
SWU-26ehicle Maintenance Activities DMR . Last Revised: August IL 2014
02of2

Semi-annual Stormwater Dischange Monitorina Report
for North Carolina Division of Water Quality Pen ral Permit No. NCGO80000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG08Q -z 2 O
FACILITY NAME Z"gf' &44s7zr--rleas/ l,.��GE�idS>A+r/ S.i�ryl
COUNTY Iif«['Z d
PERSON COLLECTING SAMPLES 6+L
LABORATORY �iQi.�il[ Lab Cert. # yO,Z
Comments on sample collection or analysis:
0
RECEIVED
JUN 2 3 2017
CENTRAL FILES
SAMPLE COLLECTION YEAR i&17 DWR SECTION
SAMPLE PERIOD Dfl Jan -June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?.X yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
❑ No discharge this period
Outfail
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Nan -Polar Oil and Grease/TPH. EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 6.0 — 9.0
15
-
* /
G Y 17
/y
.Sa
I C So
/72
vaz
17
/z
sp
/72
W* j
1,14,117
16
1 7• z o 1
<:!r. o
7Z
/f
7. O
< s.
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
/7Z
Outfa I I
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0-9.0
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date G /7 (first event sampled)
Total event Precipitation (inches):
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
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
FOR PART A AND PART B MONITORING 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 EXCEEDMCES FOR THE SAME PARAMETER AT -ANY ONE OUTFALL? YES NO
IF YES, HAVE YOU CONTACTED THE DWQ.REGIONAL OFFICE? YES 0-NO
REGIONAL OFFICE CONTACT NAME:
. - _
Mail an oriainal and one cony of this DMR, including all '"No Discharge" reports, within 30 days of receipt of the lob results for at end of monitoring period in
the case o "No Dischar ep 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."
. - 0Z7
(Date}
Additional copies of this form niay be downloaded at:.htti3://portal.ncdenr.org/:web/`­wq/ws/su/npdessw#tab-4
SWU-250 last revised April I, 2013
0 0
2 of 2

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water QualityGeneral Permit No. NCGO80000
Date submitted . � WL /6
CERTIFICATE OF COVERAGE NO. NCG08p_ jj �?
FACILITY NAME 4A4 L'a �� ,E1,G•Kr7--delfAV
COUNTY
PERSON COLLECTING SAMPLES _AW
LABORATORY PISS* . -- Lab Cert. # fo1
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR .4.40
SAMPLE PERIOD © Jan June ❑ July -Dec
or ❑ MonthW (month)
i'3�f-W606CLASS ❑ORW ❑HQW [:]Trout❑PNA
f Jl�� ` ❑Zero -flow ❑Water Supply ❑SA
JUN- 2 8 . ]Other
CENTRAL FILES
p11UR SECTION ON PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ±:yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
-Within 6.0 — 9.0
'15
-
• y-/G
I M
2
< .o
172
If
-# -/G
1 A(
G•25'
<'grx
172
03
1 !r- y • /6
I go
ae
jr-a
172
4- .K o
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
i 7A
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 — 9.0
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date G• . (first event sampled) 37
Total Event Precipitation (inches): ` 7
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
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.
FOR PART A AND PART B MONITORING 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 EXCEEDANCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO 0
- IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YM EJ NO ❑
REGIONAL OFFICE CONTACT NAME; '
4*
_Mail an oriainal and one copy of this DMR including all '"No Discharae" resorts. within 30 days of receipt of the lob results (or at end of monitorina period in
the case of "No Dischorae'" 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."
of Permittee) ✓
-:'a/ /�
(Date)
Additional copies of this form.may be downloaded at: http://Dortal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-250
last revised April 11. 2013
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted /.z - //' &/6
CERTIFICATE OF COVERAGE NO. NCG08 D Z at D
FACILITY NAME ,(wgg- A4vvdgAw r�W
COUNTY / &l%A� ey
PERSON COLLECTING SAMPLES 4LXAZ
LABORATORY- AelAW Lab Cert. # API'__
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR
SAMPLE PERIOD[] Jan -June ® July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
❑ No discharge this period'
s: Outfall
No.
Date
Sample`Collerted,
mo/dd/yr
00530
00400
00556
Tatal;5uspended
Solids, mg/L
pH,
Standard units -..
" Nor=Polar Oil and; Grease/TPH� EPA
'Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark -
-
50 or100 see,permit-
Within 60 9;d: g
15
-
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date;
Sartiple"Collected,
mo/dd/yr
00556 :..- .
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (5GT-HEM), mg/I:
°` Total Suspended Solids
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 - 9.0
1 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date q /h (first event sampled)
Total Event Precipitation (inches): 0, f
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
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.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART Il 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:
Mai! an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitoring 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 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)
%Z /6
(Date)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.oriz/web/wq/ws/su/npdesswttab-4
SWU-250 last revised April 11, 2013
Page 2 of 2

-«
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted 1.2 - /O� -42vlwl
CERTIFICATE OF COVERAGE NO. NCG08Q Z Z O
FACILITY NAME
COUNTY /lPle,�layi,P�
PERSON COLLECTING SAMPLE
LABORATORY ���'�P Lab Cert. # 'Aot
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR 120/2;1
SAMPLE PERIOD ❑ Jan -June © July -Dec
or ❑ Monthlyl (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply []SA
~, ❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
El No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 6.0-9.0
15
-
0 At
,t
13"
.�
,B ,O
122
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 — 9.0
t
1 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date �� / V (first event sampled)
Total Event Precipitation (inches):
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: if you report a somple value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING 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 ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitoring period in
the case of "No Discharge" reportstto:
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 ff Permittee)
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-250
last revised April It, 2013
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO8OOOO
Date submitted IJ
CERTIFICATE OF COVERAGE NO. NOGO8, 7 /*" e D
FACILITY NAME
COUNTY (�o
PERSON COLLECTING SAMPLES
LABORATORY- per.- - Lab Cert. #D.L
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR
SAMPLE PERIOD ❑ Jan -June [Z July -Dec
or ❑ Monthly' _ (monthl
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
_ ❑Zero -flow ❑Water Supply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
❑ No discharge this period-'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50'or 100 see permit `
Within..6.0 - 9:0
15
-
rr y ,��6
io
.90
fez o
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 — 9.0
I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Page I of 2

STORM EVENT CHARACTERISTICS:
Date / ,r /6 (first event sampled)
Total Event Precipitation (inches):
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 1, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING 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 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ No ❑
REGIONAL OFFICE CONTACT -NAME:
Mail an original and one copy of this DMR including all "No Discharge' reports within 30 days of receipt of the lab results for at end of monitoring 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 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 df Permittee)
//",to
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-250
last revised April 11, 2013
Page 2 of 2

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted W - / -,�gr
CERTIFICATE OF COVERAGE NO. NCG08Z 1 2 D
FACILITY NAME JWO
COUNTY &,G< e" CO
PERSON COLLECTING SAMPLES
LABORATORY Lab Cert. #
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR &Aw
SAMPLE PERIOD ❑ Jan -June © July -Dec
or ❑ Monthly'_- (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply [:]SA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE 3
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no
(if yes, report your analytical results in the table immediately below) '
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
❑ No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00530.
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
50 or 100 see permit
Within 6.0 — 9.0-
.904
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L .
pH,
Standard units
Permit Limit
-
15
50 or 100 see permit
6.0 — 9.0
1 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Page l of 2

STORM EVENT CHARACTERISTICS:
Date (first event sampled) �3� Total Event Precipitation (inches):
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
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.
FOR PART A AND PART B MONITORING 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 ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one copv of this DMR. includina all "No Discharge" reports. within 30 days of receipt of the lab results for at end of monitorina 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 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."
/,? - /919016
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
S WU-250
last revised April 11. 2013
Page 2 of 2