HomeMy WebLinkAboutNCG100231_MONITORING INFO_20180731STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V U& /00 a 31
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑I -7 3
YYYYM M DD
-:- STORMWATER DISCHARGE OUTFALL(SDO)
MONITORING REPORT
CERTIFICATE OF COVERAGE NO. NCGIO0231 SAMPLES COLLECTED DURING CALENDAR YEAR: 2=�_
(This monitoring report shall be received by the Division no later than 30 days
frorn the date the facility receives the sampling results from the laboratory.)
FACILITYNAME Matlock's Used Cars and Parts
PERSON COLLECTING SAMPLE S} Jeff Matlock
CERTiFIFD i gBORATi]RY(S Lab #
Lab #
Part A, Stormwater Benchmarks and Monitoring Results
COUNTY Catawba
PHONE NO. 828 ) 459-9010
RECE VE REMEMBER TO SIGN ON THE REVERSE 3
JUL 31 2018
Forsarnpling periods with nu discharge, you must submit this dischorgtm_gnfteqegrftfnoting "No Flow" or "No Discharge" within
30 days of the end of that period to comply vJ lPrg �r pe trng requirements.
t]utfall :
L '
;Date
Sam leCallerted
Arno/dt1/year
'Total
Rainfall'
inches
00400 x -
00530 '`. '
_ - `•
- 770?3 r
_ 0105!
H a
Standard
Urns
:Total $us ended
5ollds°(TSS};
t °mgJL
No oiar
d&C;fTPH 'r
(Methoi116G4
xv•.
Eth IeneGl I
rn
Lead Total
ReCoverahte, ,
mgJt
Taita6Taxlc> s;
x .Or'garnCs3; =
�' rngJL
eencl�niark
6:0 9 01_
100J502
15, n `
(Tiers and:3]'.
0.03d
L� C
Note: If you report a sampled value in excess of the benchmark value, or outsidethe benchmark range for pH, you must implement Tier 1 or Tier 2 responses in the General
Permit.
15ee If pH values outside this range are recorded in sampled stormtvater discharges, but ambient precipitation pN levels are lower, than the (ewer threshold of this benchmark
range is the pH of the precipitation (within instrument accuracy) instead of 6 S.U. Readi ,gs from an on -site or local rain gauge (or local precipitation data) must be documented
to demons rate background concentrations tvptre below the benchmark pH range of 6-9.
2See Generl Permit text to identify whether the more protective benchmark applies for especially sensitive receiving waters.
'For purposes of this permit the definition of Total Toxic Organics is that list as stated in Appendix D, Table 11 of Chapter 40 Code of Federal Regulations (CFR) Part 122•
Form 5WU-251, Iasi revised October25, 2012
Page. 1 of 2
STORPAWATER DISCHARGE OUTFALL (SDO) .
MONITORING REPORT
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may request that DWQ waive monitoring of total toxic organics. 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 allowed such a waiver, the
discharger shall sign the following certification statement:
5ol-o-ent Management Plan Certification Statement
"ga;ed cpon my ingziry c+ the parson or persons &, eztiy re5persib;e fof managing connpliance with ti,e permit monitoring requirernerit for total toxic organic; (TTA), i
certify that to the best cr my knowledge and belies, no dumping of concentrated toxic organics into the stormvrater or areas which are exposed to rainfall or
storenwater runoff has occurred since filing the last discharge mc,nitoritng report. I further certify that this facility is implementing all the provisions of the solvent
management plan included in the Stormwat Pollution Prevention Plan,
VL
Name (Pint name)
� P
Title int titles
ig tore Date
r Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
j Ra€sigh, North Carolina 27699-1617
"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 thc-t 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.
am awaret t there ar significa t enalties for submitting faise information, including the possibility of fines and imprisonment for knowing violations."
z
(Signs rmit or Designee) (Date)
Form SW U-251, last revised October 2S, 2012
Page 2 of 2
CIY) 0 (A) C,4'�-r QQ,-
yes
NC a
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
CERTIFICATE OF COVERAGE NO. NC61002-31. C �
C �V PLES COLLECTED DURING CALENDAR YEAR: 1
R This monitoring report shall be received by the Division no later than 30 days
AN 2 9 ZoSom the.date the facility receives the sampling results from the laboratory.)
FACILITY NAME MatlocWs Used Cars and Parts r^;:TRAL FILES COUNTY Catawba
PC PERSON COLLECTING SAMPjaE�S}' Jeff.Matioclt ^� �WR S �T ION / PHONE NO. 828 459-9010
—Lab N(_tV4J-U7"-i PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results
For sampling periods with no discharge, you must submit this discharge monitoring form noting "No Flovi" or "No Discharge" within
30 days of the end of that period to comply with permit reporting requirements.
<'Outfall.:A
'Date .-
_Up400
�-0a S30
. s. fi -
:.
77023 �`
�-
o1051
78141 y
lyo
Sample,Coltected;
Tata!
' pH,`
Total Suspended
-Non-polar
Ethylene Glycol;;
f Eead; l'otal'
'Total Toxic
ma/clil ar
Rainfall,
Staeidard
5ollds.(TS.S); `
O&GfTPH
mg/L
Recoverable,
;rgan 3
r
Inches
..
Units
"mgfl "
i5b4.
°
�glL
x D ,
r
f
:
E
��(Method
-
sG7-Hlrlul
�=w
4
R
6 Q :`9 0��
' 15
(Tiers 2
- fl.0.3�
Benchmark
-
dQ
;1OOj5U2
, _
and.3)t..
See mwr
Note: If you report a sampled value in excess of the benchmark valve, or outside the benchmark range for pH; you must implement Tier 1 or Tier 2 responses in the General
Permit.
`See If pH values outside this -range are recorded in sampled stormwater discharges, but ambient precipitation pH levels are lower, then the lower threshold ofthis benchmark
range is the pH of the precipitation (within instrument accuracy) instead of 5 S.U. Readings from an on -site or focal rain gauge (or local precipitation data) mustbe documented
to demcn<-trate background ccncentrations were bclo%v the benchmark pH range of 6-9.
2See General Permit text to identify whether the male protective benchmark applies for especially sensitive receiving waters.
3For purpcses of this permit the definitiun of Total Toxic Organics is that list as stated in Appendix D, Table it of Chapter 44 Code of Federal Regulations (CFR) Part 122.
Fcrm SWU-251, lost revised October 25, 2012
Page 1 of 2
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may request that QWQ waive monitoring of total toxic organics. Thesolvent
management plan shall Include a list of the total toxic organic compounds used and the other elements listed in the Generat Permit. For those facilities allowed such a wdiver, the
discharger shall sign the following certification statement:
Solvent Management Flan Certification Statement
"Based upoa my inquiry Gf Cie person or persons directly responsibl_ fur managing compli:i ce �,vith the perinil monitoring requirement for total toxic organics (TTO), I
certify teat to the hest of my knowledge and belier, no dumping of concentrated toxic organics into the Stormwater or areas which are exposed to rainfall or
stern water runo- has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing all the provisions of the solvent
management plan included in the Stormwater Pollution Prevention Plan."
AW)LIoAc- &� —
Name (Print name)
Jana ,
_ 2t(Qt _
ignature Date
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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
any. aware that therWare slgnifignt penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Farm SWU-251, last revised October25, 2012
Page 2 of 2
•
ir5m
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: http-,I/pQMI.ngdenr.org/wcb/wQ/.w-sau/npdess.w#tab-4
r.org/wcbfwQ/wsau/npdessw#tab-4
Permit No.:
Facility Name:
County:
Inspector: 2mo�
Date of Inspection: _
Time of Inspection: _
V--
or Certificata of Coverage No.:
Total Event Precipitation (inches): o W 5
Phone No.
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains anmroval from the local DWO Regional Office.
By this s)gnature, I certify,th4 this report is accurate and complete to the best of my knowledge:
of Permittee or Designee)
Pagel of 2
SWU-242, Last modified 10/25/2012
1. Outfall Description:
Outfall No. �_ Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area: e C o try
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: VmY-)
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc,):
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
1 2 D3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 (2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 2 ( D3
4 5
7. Is there any foam in the stormwater discharge? Yes No
8. Is there an oil sheen in the stormwater discharge? Yes C:No)
9. Is there evidence of erosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
List and describe ._�A- .
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition.
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Wtmodified 10/25/2012
aehrhhv.h�lpdabf.dom
QUALITY CONMOL DATA
Non -Halogenated Seuhlralardle Organics by GC - Quallty Control
E21" A402016 - MA
81ank (SA020WOLR1) Prepared, 01/02/2019 10:06 Armlrad: 01/02/2018 10:21
Spike Souris %RLC RPO
A"IVW
Re ult
flag
Pat
Unha Level Rwug 41,RRC Iimika RPO LM Not"
Dietlrylelm G"
3.6
U
10
qwL
Ethylene G ycvl
4.7
U
5.0
nq/L
Proprkne G VW
4.3
U
5.0
nwL
Trklhylene Glyod
6.9
_
U
10
mglL
2,.! &O Eire C4%w
I10
mw AV 1Rr .R>-M
LCS (S"2018.9SI)
Prepared: 01/02/2018 10:06 Analyzed: 01/02/2018 IOAO
Spike source %NRC R1P0
Anobte
ResuR flan
VOL
Uelra
Level Rmul) %URRC UmI((A RPD lftflft tltlliCi
Die rO— lFymt
19D
10
mg/L
2D0 95 70-130
Et rAw G"
200
5-0
mg/L
200 102 70-130
Propylare G"
490
5.0
rng/L
200 9e 70�130
lr thylene C*W
170
10
mg/L
200 85 70-130
1,34wryAsreWar
190
mh1/2
200 96 502r.0
LC! Pup (0"20164MVI)
Prepared: 01/02/2015 10:06 /Yatyzad: 01/02/2018 L1:00
Splka Soma
%RCC
11P0
Anih60
RON&
Pau POL
Units
Level 8mft
%R[C
LhOft
RPD
limit MACL
Dk drt4 a {,lyml
17D
10
mg/L
200
89
70.130
12
25
EOW— Glyrol
200
5.0
mg/L
200
ID2
70.130
0.7
25
l4opyw* Gly001
18U
S.0
mg/L
2ilU
92
AMN
2
6
TrkUrykneGlyrd
ISO
10
m0/L
200
76
70-130
11
2S
1,J-&O& r GYCO( Ia7 rrlyt lno 90 511150
FINAL This nupM nWat only to the pl a ,a0WAd by tM ub&AWy, ed may o * b. r�edrod In kd. Papa S of 7
PO Box 228 - Statesville, NC 28687 - 704/872/4697
Page 7 of 9
CeM1131000)
VOWW�
ANALYTICAL RESULTS
Descliptlon: 17MI.23.01 Lab Sample LO:CA19763.01 Received: 12/22117 10:10
Matrix: Waste Water Sampled:12J20117 10:55 Work Order. CA19763
ProjeW General5ubaantrad Sampled By:Cllent
NOn-Halogenated 9etnivolatife Organks by GC
Jlnalvle_ ICAS Hwnberl
Resu 1
IM VM
QE
M"
ERL
am
M
Anetlaffi
fg mom
Ole� Ghrad 1111-46.6]
c 3.6
MOIL
1
3.6
10
8A02016
EPA 8015C
01107JI9 13:11
JIB
Ethyle m Glycol[107 21.11
c 4.7
M91L
1
4.7
5.0
OM2016
EPA OOISC
01102J19 13:11
JIB
Prmylme Glycol [57-$5{]
< 4.3
m9/L
1
4.3
so
W2016
EPA 8015C
OIIOZ118 13:11
JJO
TrledWWr a Glyc* [112.27.61
K 6.9
myL
1
6.9
10
U02036
EPA 8015C
01/02/18 13al
1JB
SAITYP"tM
&F AwffiaA
96Rae
lntAr
Ji 2
SY Ran
11.?-Mllyh nw
PO
r Nr7
fM 96
SA-I.SR
AAWOIK
FAA MILSr
01/w/IF 1.7. 11
JN
FINAL 7h4 A m realm ** to tM uw4%* as ncWnd by IM b bwat % and may o* bo rpodroa . h tee.
"4 of 7
PO Box 228 • Statesville, NC 28687 - 704/872/4697
Page 6 of 9
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
CERTIFICATE OF COVERAGE NO. NCG100231 SAMPLES COLLECTED DURING CALENDAR YEAR: 20/1�7
(This monitoring report shall be received by the Division no later than 30 days
from the date the facility receives the sampling results from the laboratory.)
FACILITY NAME Matlock's Used Cars and Parts COUNTY Catawba
PERSON COLLECTING SAMPLE(S) Jeff Matlock PRONE NO. 828 ) 459-9010
CERTIFIED LABORATORY(S) Lab # RECEIVED
Lab #jo 0 2017 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results CENTRAL FILES
DWR SECTION
Forsampling periods with no discharge, you mustsubmit this discharge monitoring form noting "No Flow" or "No Discharge" within
30 days of the end of that period to comply with permit reporting requirements.
No.. =
-Date`
Sample Collected,
mo/dd/year :'
s:
; .
Total
Rainfall,
.inches'
rt'.: ..00400 „;
.- 00530-
__ ...
,.. ..
01051 eta
aS_
pH,
Standard
Units.
Total Suspended
Solids (TSS)
mg/L
-
Non-potar
O&G/TPIi
.(Method 1664
..SGT-HEM),mg/L/
Ethylene Glycol;'
mg/L:
Eead'Total :-'-Total
Recoverable,
mg/L
Toxic
'- 3
Organics
m L
Benchmark
-
-
6A — 9.01
_ 100/502.
<
8000
(Tiers 2 and 3).
0.03
1.0
r
WV
Note_ If you report a sampled value in excess of the henchmark value_
or outside the henchmark ranee for nH. you must implement Tier 1 or Tier 2 resnonses in the General
Permit.
1See If pH values outside this range are recorded in sampled stormwater discharges, but ambient precipitation pH levels are lower, then the lower threshold of this benchmark
range is the pH of the precipitation (within instrument accuracy) instead of 6 S.U. Readings from an on -site or local rain gauge (or local precipitation data) must be documented
to demonstrate background concentrations were below the benchmark pH range of 6-9.
2See General Permit text to identify whether the more protective benchmark applies for especially sensitive receiving waters.
3For purposes of this permit the definition of Total Toxic Organics is that list as stated in Appendix D, Table 11 of Chapter 40 Code of Federal Regulations (CFR) Part 122.
Form SWU-251, last revised October25, 2012
Page 1 of 2
4ro
STORMWATER DISCHARGE OUfFALL (SDO)
MONITORING REPORT
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may request that DWQ waive monitoring of total toxic organics. 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 allowed such a waiver, the
discharger shall sign the following certification statement:
Solvent Management Plan 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), 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 facility is implementing all the provisions of the solvent
management plan included in the Stormwater Pollution Prevention Plan."
Name (Print name)
/
Title (PrInj title
+I. A 'l./.ice
Date
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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 significa penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee or
/";_-,a
(Date)
Form SWU-251, lost revised October 25, 2012
Page 2 of 2
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
CERTIFICATE OF COVERAGE NO. NCGIO0231 SAMPLES COLLECTED DURING CALENDAR YEAR: ZD
(This monitoring report shall be received by the Division no later than 30 days
from the date the facility receives the sampling results from the laboratory.)
FACILITY NAME Matlock's Used Cars and Parts COUNTY Catawba
PERSON COLLECTING SAMPLE(S) Jeff Matlock PHONE NO. 828 459-9010
CERTIFIED LABORATORY(S) Lab #
Lab # RCE WE REMEMBER TO SIGN ON THE REVERSE
Part A: Stormwater Benchmarks and Monitoring Results
AUG 0 12011
CENTRAL FILES
For sampling periods with no discharge, you must submit this discharge:?WR4W)9A noting "No Flow" or "No Discharge" within
30 days of the end of that period to comply with permit reporting requirements.
Outfall -
No. i
Date.
Sample Collected,
mo/dd/year
-
t . Total
Rainfall,
inches .
00400
00530
- - - -
77023
01051
78141
pH,
Standard
Units
Total SuspendedH-
Solids (TSS)''.
mg/L -
' Non -polar
O&G/TPH
-(Method 1664
-SGT-HEM), mg/L
Ethylene Glycol,
mg/L
Lead, Total
Recoverable,
mg/L
Total Toxic
organics3,
mg/L
Benchmark
-
-
6.0-9.01
100/502
- 15
8,000
(T'iers2�and3)
0.03
a
1.0
1
[, 7
C 4x)
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses in the General
Permit.
1See If pH values outside this range are recorded in sampled stormwater discharges, but ambient precipitation pH levels are lower, then the lower threshold of this benchmark
range is the pH of the precipitation (within instrument accuracy) instead of 6 S.U. Readings from an on -site or local rain gauge (or local precipitation data) must be documented
to demonstrate background concentrations were below the benchmark pH range of 6-9.
2See General Permit text to identify whether the more protective benchmark applies for especially sensitive receiving waters.
3For purposes of this permit the definition of Total Toxic Organics is that list as stated in Appendix D, Table II of Chapter 40 Code of Federal Regulations (CFR) Part 122.
Form SWU-251, lust revised October25, 2012
Page 1 of 2
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may request that DWQ waive monitoring of total toxic organics. 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 allowed such a waiver, the
discharger shall sign the following certification statement:
Solvent Management Plan 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), 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 implementing all the provisions of the solvent
management plan included in the Stormwater Pollution Prevention Plan."
SE_F_i-- MA it g=
Name (Print name)
TRUE55 1-DE�N�
Title (Print t )
/I ///7-mil 7
Si a Date
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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 thQre are significant penes for submitting false information, including the possibility of fines and imprisonment for knowing violations."
or
7 ,Z. 17
(Date)
Form SWU-251, last revised October 25, 2012
Page 2 of 2
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
CERTIFICATE OF COVERAGE NO. NCGIO0231 RECEIVED%MPLES COLLECTED DURING CALENDAR YEAR:
(This monitoring report shall be received by the Division no later than 30 days
JUL 0 5 ?016 from the date the facility receives the sampling results from the laboratory.)
FACILITY NAME _Matlock's Used Cars and PartsCENTRAL FILES
_ _ rnn�ca C FILES
COUNTY Catawba
PERSON COLLECTING SAMPLE(S) Jeff Matlock PHONE NO. 828 459-9010 navre
CERTIFIED LABORATORY(S) Lab # 6 w
Lab # PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results
For sampling periods with no discharge, you must submit this discharge monitoring form noting "No Flow" or "No Discharge within
30 days of the end of that period to comply with permit reporting requirements. 0
Qutfall ry
No
Date -
Sample Collected,
Total
00406
"OU530"
_ _ "-
=:
77023
01051.:
8141,
pH,
Total Suspended
Non -polar
Ethylene Glycol,
Lead, Total
OI To'xic
ino/dd/year
Rainfall,
Siandard
Solids (T5S},
O&G%TPii
mg/L
Recoverable, �`Orgamrs3,
inches
Units
mg/L.
(Met,hod1664
,
SGT-HEM), mg/L
8,000
Benchmark
-
-
6:0 — 9 01 , :
100/50
15
(Tiers 2 and. 3) -
01,031
,,
1.0
IL
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses in the General
Permit.
1See If pH values outside this range are recorded in sampled stormwater discharges, but ambient precipitation pH levels are lower, then the lower threshold of this benchmark
range is the pH of the precipitation (within instrument accuracy) instead of 6 S.U. Readings from an on -site or local rain gauge (or local precipitation data) must be documented
to demonstrate background concentrations were below the benchmark pH range of 6-9.
2See General Permit text to identify whether the more protective benchmark applies for especially sensitive receiving waters.
3For purposes of this permit the definition of Total Toxic Organics is that list as stated in Appendix D, Table II of Chapter 40 Code of federal Regulations (CFR) Part 122.
Form SWU-251, last revised October25, 2012
Page 1 of 2
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may request that DWQ waive monitoring of total toxic organics. 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 allowed such a waiver, the
discharger shall sign the following certification statement:
Solvent Management Plan 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), 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 facility is implementing all the provisions of the solvent
management plan included in the Stormwater Pollution Prevention Plan."
*D MCAcL
Name (Print nam`
Title (Print title)
-9-147
Date
Mail Original and one copy to:
Division of water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
or Design
&-0-%V
(Date)
Form SWU-251, last revised October25, 2012
Page 2 of 2
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
0--
r��
CERTIFICATE OF COVERAGE NO. NCG100231 - SAMPLES COLLECTED DURING CALENDAR YEAR: -y /5
(This monitoring report shall be received by the Division no later than 30 days
#ram the date the facility receives the sampling results from the laboratory.)
FACILITY NAME Matlock's Used Cars and Parts COUNTY Catawba
PERSON COLLECTING SAMPLE(S) Jeff Matlock PHONE NO. 828 459-9010
CERTIFIED LABORATORY(S) Lab #
Lab # PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results
For sampling periods with no discharge, you must submit this discharge -monitoring form noting "No Flow" or "No Discharge" within
30 days of the end of that period to comply with permit reporting requirements.
Dutfall �- Date '' 00400°
No Sample Coilected, Total ' pH,
rrio%dii/year> Rainfall, j Standard
t inches Units
Benchmark.
00530
01051`
otASuspended
Non=polar`
T Ethylene Glycol, .=
Lead, Total '
Solids;(T55), s
O&G/TPH
t Recoverable,
mg/L
'(Method`16364
mg/L
-SGT=HEM), mg/L'
_
8 G00
x
10050 -:
-15.-(TiersfAnd
3)
.. f).03.
3
„ Organics ,
~ mg/L
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses in the General
Permit.
1See If pH values outside this range are recorded in sampled stormwater discharges, but ambient precipitation pH levels are lower, then the lower threshold of this benchmark
range is the pH of the precipitation (within instrument accuracy) instead of 6 S.U. Readings from an on -site or local rain gauge (or local precipitation data) must be documented
to demonstrate background concentrations were below the benchmark pH range of 6-9.
2See General Permit text to identify whether the more protective benchmark applies for especially sensitive receiving waters.
3For purposes of this permit the definition of Total Toxic Organics is that list as stated in Appendix D, Table li of Chapter 40 Code of Federal Regulations (CFR) Part 122.
Form SWU-251, lost revised October25, 2012
Page 1 of 2
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STORMWATIER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may request that DWQ waive monitoring of total toxic organics. 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 allowed such a waiver, the
discharger shall sign the following certification statement:
Solvent Management Plan 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), 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 facility is implementing all the provisions of the solvent
management plan included in the Stormwater Pol tion Prevention Plan."
film a
Name (Print name)
8:r Panaaer
Title (Print title)
12-31-1 s
signature Date
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Permittee or Designee)
(Date)
Form 5WU-251, lost revised October 25, 2012
Page 2 of 2
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
CERTIFICATE OF COVERAGE NO. NCG100231
FACILITY NAME Matlock's Used Cars and Parts
PER50N COLLECTING 5AMPLE(5) Jeff Matlock
CERTIFIED LABORATORY(S) Lab #
Lab #
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLES COLLECTED DURING CALENDAR YEAR:
(This monitoring report shall be received by the Division no later than 30 days
from the date the facility receives the sampling results from the laboratory.)
COUNTY Catawba
PHONE NO. 828 459-9010
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
For sampling periods with no discharge, you must submit this discharge monitoring form noting "No Flow" or "No Discharge" within
30 days of the end of that period to comply with permit reporting requirements.
No
Date; ,
5acn`ple;Coilected
Total
.:�00400`�
4
4'1
.,0053Q�
_- _ _
•77023 ,
01051
78141
` _ H
Total. Suspended
Nan=polar.:
Ethylene Glycol,
Lead, Total
to Toxic
mo/dd/year
Rainfall,
Standard
Solids {TSS),
O&G/TPH
mg/L
Recoverable;
3
Organics
inches
Units
mg/L
(Method 1664
ni V
,
g/
S_GT-HEM), mg/L
;
Benchmark'. ,
` . _ °
,.,.
6 0 - 4.01
100/54:
15
{T 8;000
iers 2 and 3)
0.03 ��.
,
a lA .
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses in the General
Permit.
1See If pH values outside this range are recorded in sampled stormwater discharges, but ambient precipitation pH levels are lower, then the lower threshold of this benchmark
range is the pH of the precipitation (within instrument accuracy) instead of 6 S.U. Readings from an on -site or local rain gauge (or local precipitation data) must be documented
to demonstrate background concentrations were below the benchmark pH range of 6-9.
2See General Permit text to identify whether the more protective benchmark applies for especially sensitive receiving waters.
3For purposes of this permit the definition of Total Toxic Organics is that list as stated in Appendix D, Table II of Chapter 40 Code of Federal Regulations (CFR) Part 122.
Form SW U-251, last revised October 25, 2012
Page 1of2
I
}) �
�� \
�� � \
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may request that DWQ waive monitoring of total toxic organics. 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 allowed such a waiver, the
discharger shall sign the following certification statement:
Solvent Management Plan 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), 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 facility is implementing all the provisions of the solvent
management plan included in the Stormwater Pollution Prevention Plan."
Akndr
A -Hach
Name (Print name)
/fl? &ad
Title (Print title)
Signature Date
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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."
Permittee or
/Z3-/s
(Date)
Form SW U-251, last revised October 25, 2012
Page 2 of 2
,yo
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
RECEIVED
CERTIFICATE OF COVERAGE NO. NCG100231 SAMPLES COLLECTED DURING CALENDAR YEAR:
AUG 0 3 2015. This monitoring report shall be received by the Division no later than 30 days
CENTRAL. FILEgam the date the facility receives the sampling results from the laboratory.)
DWR SECTION
FACILITY NAIME Matlock's Used Cars and Parts COUNTY Catawba
PERSON COLLECTING SAMPLE(S) Jeff Matlock PHONE NO. 828 ) 459-9010
CERTIFIED LABORATORY(S) Lab #
Lab # PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results
For sampling periods with no discharge, you must submit this discharge monitoring form noting "No Flow" or "No Discharge" within
30 days of the end of that period to comply with permit reporting requirements.
Outfall
No.
Date
Sample Collected,
mo/dd/year
-
Total
Rainfall,
inches
00400
00530
- - - -
77023
01051 _ .
78141 .
pH,
Standard
Units
Total Suspended
Solids (TSS),""-.'
mg/L
g/
Non -polar- '
O&G/TPH
{Method 1664
SGT HEM); mg/L ,
Ethylene. Glycol,
mg/L -
Lead, Total
Recoverable,
mg/L
Total Toxic
3
Organics ,
mg/L
Benchmark
-
-
6.0 — 9.0
100/502
15
8,000
(Tiers 2'and 3)
0.03
1.0
Note: If you reoort a sampled value in excess of the benchmark value.
or outside the benchmark ranee for oH.
you must implement Tier 1 or Tier 2 resoonses in the General
Permit.
1See if pH values outside this range are recorded in sampled stormwater discharges, but ambient precipitation pH levels are lower, then the lower threshold of this benchmark
range is the pH of the precipitation (within instrument accuracy) instead of 6 S.U. Readings from an on -site or local rain gauge (or local precipitation data) must be documented
to demonstrate background concentrations were below the benchmark pH range of 6-9-
2 See General Permit text to identify whether the more protective benchmark applies for especially sensitive receiving waters-
3Forpurposes of this permit the definition of Total Toxic Organics is that list as stated in Appendix D, Table II of Chapter 40 Code of Federal Regulations (CFR) Part 122.
Form SWU-251, last revised October 25, 2012
Page 1 of 2
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may request that DWQ waive monitoring of total toxic organics_ 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 allowed such a waiver, the
discharger shall sign the following certification statement:
Solvent Management Plan 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), 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 facility is implementing all the provisions of the solvent
management plan included in the Stormwater Pollution Prevention Plan."
:J-�4 Mate) C-�
Name (Print name)
PYe--stOe,124�
Title (Print title) Q
v
ig re
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
7-ao-rS
Date
"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 pbrialties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
or Designee)
(Date)
Form SWU-251, last revised October25, 2012
Page 2 of 2