NCG080800_COMPLETE FILE - HISTORICAL_20130122

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO. I Iv � CJ Y 0j-60
DOC TYPE I ;K HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE I ❑ 9013 1 a%i
YYYYM M DD

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41*
A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Pat McCrory Charles Wakild, P.E. John E. Skvarla, III
Governor Director Secretary
January 22, 2013
Mr. Roger Stancil
Town of Chapel Hill
405 Martin Luther King Jr. Blvd.
Chapel Hill, NC 27514
Re: Chapel Hill Municipal Operations
6850 Mill House Rd
Chapel Hill, NC 27516
SUBJECT: Compliance Evaluation Inspection
Chapel Hill Municipal Operations
Permit Number - NCGO80800
County- Orange
Dear Mr. Stancil:
On November 30, 2012 Autumn Romanski, of the Division of Water Quality (DWQ), Raleigh Regional Office,
performed a stormwater compliance evaluation inspection of the Chapel Hill Municipal Operations Site off Millhouse
Road in Orange County. The Town of Chapel Hill Staff, Ms. Sue Burke and Mr. Robert Sykes were helpful and
their assistance to complete the inspection evaluation was greatly appreciated. Please review the Compliance
Inspection Report enclosed for inspection details.
A summary of the inspection findings is listed below.
IndUStryand;SrteDescniptror� �. �� A_-
The Town of Chapel Hill Municipal Operations Site contains maintenance garage(s), re -fueling stations, and above
ground storage - bulk oil storage (that is covered under the federal SPCC Regulations). Stormwater runoff
generated at such facilities is regulated by General Permit NCG080000. DWQ has therefore issued Chapel Hill
Municipal Operations Site certificate of coverage, NCG080800, which became effective on 12-12-2012 and expires
on 10-31-2017.
inspectidrt Smmar0.
._ --�
The facility was in compliance with the permit requirements the day of the inspection. The staff was knowledgeable
and the facility has Best Management Practice's (BMP's) in place. Much of the stormwater discharge is captured
for reuse at the site. No stormwater outfalls were observed discharging to surface waters the day of the inspection.
The transport garage appears to have a source of fuelloil entering the stormwater detention pond. It also appeared
that the detention pond may be short circuiting, as the full capacity of pond was not being utilized as evident by the
North Carolina Division of Water Quality 1628 Mail Service Center Raleigh, NC 27699-1628 Phone [phone] Customer Service
Internet: wtirtiv.ncwaterquality.org Location: 3800 Barrett Drive Raleigh, NC 27609 Fax [phone]
An Equal OpportunitylAffirmatnre Action Employer— 50% Recycledl10% Post Consumer Paper NoAhCarohna
Naiima!!u

current stormwater flow pattern. Please identify, correct, and provide a written report on the issues observed the at
the transport garage the day of the inspection.
It is our goal to insure the quality of the surface waters of this State.
If you have questions about the inspection report, or if we can be of further assistance, please contact Autumn
Romanski at 919-791-4200.
Sincerely,
Autumn Romanski
Enclosures
Cc: Central files
RRO Files

Permit: NCG080800
SOC:
County: Orange
Region: Raleigh
Compliance Inspection Report
Effective: 11/01/07 Expiration: 10/31/12 Owner: Town of Chapel Hill
Effective: Expiration: Facility: Chapel Hill Municipal Operations
1099 Airport Rd
Contact Person: Robert Vander Sykes
Directions to Facility:.
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Chapel Hill NC 27516
Title: Phone: [phone]
Certification: Phone:
Inspection Date: 11I3012012 Entry Time: 02:00 PM Exit Time: 04:00 PM
Primary Inspector: Autumn H Romanski Phone: [phone]
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Transportation wNehicle Maintenance/Petroleum Bulk/Oil
Water Se arator Stormwater Discharge COC
Facility Status: ■ Compliant Not Compliant
Question Areas:
E Storm Water
(See attachment summary)
Page: 1

Permit: NCG080800 Owner - Facility: Town of Chapel Hill
Inspection Date: 11/30/2012 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
The facility was compliant with the permit requirements the day of the inspection with the exception of maintenance of
inspection and monitoring records on -site. The facility forwarded the results after the inspection and was requested to
keep records on -site going forward.This site was designed to harvest and re -use rainwater, this lessens the amount of
stormwater discharges.
Page: 2

Permit: NCG080800 Owner - Facility: Town of Chapel Hill
Inspection Date: 11 /30/2012 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Stormwater Pollution Prevention Plan Yes No NA NE
Does the site have a Stormwater Pollution Prevention Plan?
# Does the Plan include a General Location (USGS) map?
# Does the Plan include a "Narrative Description of Practices"?
# Does the Plan include a detailed site map including outfall locations and drainage areas?
# Does the Plan include a list of significant spills occurring during the past 3 years?
# Has the facility evaluated feasible alternatives to current practices?
# Does the facility provide all necessary secondary containment?
# Does the Plan include a BMP summary?
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
# Does the facility provide and document Employee Training?
# Does the Plan include a list of Responsible Party(s)?
# Is the Plan reviewed and updated annually?
# Does the Plan include a Stormwater Facility Inspection Program?
Has the Stormwater Pollution Prevention Plan been implemented?
Comment: The plan was complete and has been implemented. This facility has bulk
above ground fuel storage and falls under Federal SPCC Program with regards to
secondary containment. Training was last completed in August 2011. The plan was
last updated October 7, 2011.
Qualitative Monitoring
Has the facility conducted its Qualitative Monitoring semi-annually?
Comment: The facility has contracted a consulting firm to conduct inspections and
monitoring at Outfall SDO #001-004. The consultant was not available the day of the
inspection, so records were faxed in after the inspection. The facility was requested to
be keep the records on -site going forward.
Analytical Monitoring
Has the facility conducted its Analytical monitoring?
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas?
Yes No NA NE
■ODD
Yes No NA NE
■nn0
Page: 3

Permit: NCGO80800 Owner - Facility: Town of Chapel Hill
Inspection Date: 11/30/2012 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Comment: The facility has contracted a consulting firm to conduct sampling at Outfall
SDO #001-004. Outfalls 002-004 were dry and likely remain dry or have inadequate
flow for representative sampling so no flow is documented as required. The facility
harvests and stores rainwater for reuse. This practice and the dry stormwater basins
appear to store the rainwater, no discharges from the dry basins appeared likely.
Outfall #001 had a slight discharge the day of the inspection. There was also a light
sheen at the outfall. The permittee was requested to investigate the origin of the sheen,
as the outfall is located by the Transit garage. Also, the facility was requested to
provide monitoring results for this outfall, if any were taker,.
Permit and Outfalls
# Is a copy of the Permit and the Certificate of Coverage available at the site?
# Were all outfalls observed during the inspection?
# If the facility has representative outfall status, is it properly documented by the Division?
# Has the facility evaluated all illicit (non stormwater) discharges?
Comment. All Stormwater SDO outfalls were observed the day of the inspection. The
discharge at Outfall 001 seen teh day of teh inspection should be reviewed and
adjustments made to the treatment unit (short circuiting) or preventative measures taken
at the Transit Garage to ensure solvents/fuel do not discharge to surface waters.
Yes No NA NE
Page: 4

i
Romanski, Autumn
From: Sue Burke [[e-mail]]
Sent: Thursday, January 03, 2013 3:10 PM
To: Romanski, Autumn
Subject: FW: TOC industrial permit inspection by DWQ
Attachments: image001.9if; Completed Form 3 dated May 2010_pdf; Completed Form 5s from 12-7-11 to
8-6-12. PDF
hi Autumn,
I'm so sorry; I thought I already forwarded this to you. Please let me know if you have any questions.
Thank you,
Sue
Sue Burke, P.E., CFM
Stormwater Management Engineer
Town of Chapel Hill
[phone]
[e-mail]
From: O'Connor, Dan [maiito:[e-mail]]
Sent: Friday, December 07, 2012 8:32 AM
To: Ernest Odei-Larbi
Cc: Sue Burke
Subject: RE: TOC industrial permit inspection by DWQ
Ernest —
Attached please find the following completed forms for Public Works Complex and Transit Facility:
- Completed Non-Stormwater Discharge Assessment, dated May 2010.
After we conducted the August 2011 training, we submitted the May 2010 Nan-Stormwater Discharge Assessment form to
the Town on August 31, 2011 and a Town official was to sign the "Certification of Non-Stormwater Discharges (page iv in
SWPPP) at same time as he/she signed the SWPPP Certification (page iii).
I am not sure if DWQ Regional inspector requested to see an updated Certification form or if the May 2010 signed version
satisfied them, so let me know.
Also, please find attached completed forms for Public Works Complex and Transit Facility:
- Completed Stormwater Discharge Outfall (SDO) Qualitative Monitoring Reports, dated 12/7/2011
- Completed Stormwater Discharge Outfall (SDO) Qualitative Monitoring Reports, dated 12/21/2011
- Completed Stormwater Discharge Outfall (SDO) Qualitative Monitoring Reports, dated 1/11/2012
- Completed Stormwater Discharge Outfall (SDO) Qualitative Monitoring Reports, dated 2/27/2012
- Completed Stormwater Discharge Outfall (SDO) Qualitative Monitoring Reports, dated 6/6/2012
- Completed Stormwater Discharge Outfall (SDO) Qualitative Monitoring Reports, dated 8/6/2012
I will drop off hardcopies of these forms to your office sometime this morning, and if I miss you, I will call you to discuss
them.

I am not sure if DWQ is requesting to see copies of our Form 5 observations or a copy of completed and signed Form 3,
but I think a simple letter to DWQ from the Town should suffice that indicates something to the effect ...... that the facility
outfalls are being monitored and that (other than flow at only two points on 1217111 during the initial visual only
observations performed by consultant) we have had no flow at the basin outfalls. We will continue to conduct wet
weather monitoring at the facility outfalls, documenting visual observations, with a goal of collecting grab samples to
analyze at facility basin outfalls during representative rain storm events.In addition, we are investigating options of
installing an automated rain gauge with alerts to smart phones to aid us in this effort." Copies of these forms can be
provided to DWQ if that is what they want to see.
Hope this helps. I will drop off additional hardcopies at the facility for Robert to insert into his binder as well.
Dan
From: Ernest Odei-Larbi [maiIto: [e-mail]
Sent: Wednesday, December 05, 2012 10:34 AM
To: O'Connor, Dan
Subject: FW: TOC industrial permit inspection by DWQ
Dan,
As I discussed with you, we will paperwork for the grab sample and the certification if there was no discharge. Please
reference the email below.
0 a Ernest Odei-Larbi, PE,CFM
Stormwater Engineer
Public Works Department
Stormwater Division
Town of Chapel Hill
208N. Columbia St.
Chapel Hill, NC 27514-5705
Phone: [phone]
Fax: [phone]
From: Brian Litchfield
Sent: Friday, November 30, 2012 5:02 PM
To: Sue Burke
Cc: Lance Norris; Jay Gibson; Robert Sykes; Ernest Odei-Larbi; Chris Jensen
Subject: Re: TOC industrial permit inspection by DWQ
Thanks for the update and we look forward to hearing from Ernest.
BML
Sent from my iPhone
On Nov 30, 2012, at 4:54 PM, "Sue Burke" <[e-mail]> wrote:
All,
The TOC was inspected this afternoon by Autumn Romanski from the NC Division of Water Quality
(DWQ) Raleigh Regional Office. The inspection went fairly well with only two items to address.

The first is some paperwork for the grab samples, I'll have Ernest follow up with our consultant
when he returns to the office next week.
The second issue concerned a slight sheen at the Transit outfall. There appears to be a petroleum
product (color, odor) in the Transit basin foreboy. I'm not sure if there was a recent spill or if
vehicles are leaking (there are oil patches on the pavement). Transit will need to identify the
source, correct it, and clean out the basin. Brian, I'll ask Ernest to follow up with you next week
also. Well have to submit a status report to DWQ after the work is complete.
Please let me know if you have any questions.
Thank you,
Sue
Sue Burke, P.E., CFM
Stormwater Management Engineer
Town of Chapel Hill
[phone]
[e-mail]
This e-mail and any attachments contain URS Corporation confidential information that may be proprietary or privileged. If you
receive this message in error or are not the intended recipient, you should not retain, distribute, disclose or use any of this
information and you should destroy the e-mail and any attachments or copies.

FORM 5
STORMWATER DISCHARGE OUTFALL (SOO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO N00080000
FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE
DATE: tzVzlott
INSPECTOR• fefte_
TIME: Qrt
OUTFALL No. ,
OUTFALL TYPE
RECEIVING STREAM:
SOO- OD 1
I I D TCH PIPE I I CHANNEL
I 09-b FIE -Lb C4WV_/ N 46M
Flow observadar: )(Flow i I No flow
Describe the industrial activities occurring wttihln the ouf o drabutge area.
TA*,W. f r fw (stir a WrP6
COLOR - 0uhgcr0 a the discharge color (e g. red, brown, green, bhhe) and tint (eag., tight, medhpn, dark).
ODOR - Describe any distinct odors (94 gasoUne, .alter eggs, chlorine) the discharge may hare.
tJe�E .
CLARITY - Choose the ruasbw treat best rwft the udarity of the dhwft rge4 where 1 Is dear and 10 Is very
dowdy.
1 2 3 4 5' 6 7 8 9 10
FLOATING SOLIDS - Choose the ru rnber that best ranks the amount at floating solids in the discharge,
where 1 Is no solids and 10 Is thee surkm covered with fleeting solids.
1 2 3 4 © 6 7 8 9 10
SUSPENDED SOLIDS - Choose the number that best runks the errrou d of suspended solids In the discharge;
where 1 Is no solids and 101s eutternely ruddy
1 2 3 4 5 6 7 9 10
FOAM
Is there any foam on or in the stormwater dugs? yes,
OIL SHEEN
Is there an oil sheen visible on the storrnwater ? no
EROSION AT OUTFALL
Is there go erosion at or near the vk of the outfaiP
List and describe other obvious Indloators atstonmrahn pollution:
wma hr ahctAr Fisidlfre, I WenA^S — &Wr-f& Wf tort
P l PE Awn- T [MWAhfW t;-~ *Jr- e. KLei-5 S kMed
13y this sIgnahn e, I certify that this report Is accurate and complete to the best of my knowledge:
or
Reference Secft? 1.4.4

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO. NCGO80000
FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE
DATE: I y -7Za l l
INSPECTOR:1 h+ Qk-'cN oe
TIME: S: 4 S p M
OUTFALL No.
OUTFALL TYPE:
RECEIVING STREAM: K
SDO- Qp 2
11 DFTCH PIPE t I CHANNEL
OMLD F�Es� GR �
Flow obswvatkwc i i Flom No flaw
Describe the hubm&W aWvides occurring wwdn the outfell drairrege arm.
PitSW C uof4es F:hcj . " L s Eir s r"rrPe
COLOR - Describe the discharge color (e.% red. blow. f, 9F00n. bkW)arrd tit t (&g•. light, medlum. dark).
,
ODOR - Describe any distinct odors (s g. gasoline. -atimr eggs, ctio bw) the discharge melt hare:
CLARITY - Choose the number that bast ranks the clarity of the discharge, where 1 is dear and 10 is very
cloudy.
10-0*0 1 2 3 4 5 6. 7 8 9 10
FLOATOG SOLIDS - Choose the cumber that best ranks the amount of floe" solids in the discharge,
where 1 is no solids and 10 Is the surface covered with Noetlng solids.
1 2 3 4 5 6 7 8 9' 10
SUSPENDED SOLIDS - Choose the number that best ranks the amount of suspercted solids In the dischin gs,
where 1 Is no solids and 10 Is entr�ero y► muddy.
1 2 3- 4 5 6 7 8 9 10
FOAM �,
Is there any foanf on or In the shmm water disdfarge? yes �J
OIL SHEEN
Is there an oil sheen visible on the stannwater discharge? yes 4ro-)
EROSION AT OUTFALL
is there any erosion at or near the vicinity of the ontlail?
List and describe other obvious Indicators of stormwater polhrtion:
rto F,ow A-T oumter- p(pe of gTaww+r mt eimi ri #2
By this sigm tur% I owtify #0 this report Is accurate and complete to the best of my iutowisdga:
ofP&m&'w o►D"
Reference Secfon 1.4.4

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPOES PERMIT NO. NCG080000 FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE DATE: 17.171 Td if
INSPECTOR: TIME: 5: do FK
OUTFALL No. OUTFALL TYPE: .
RECEIVING STREAM: d4A PjttD
SOO- 4o3 I I DITCH )OWE i I CHANNEL
HOPE adee
Flow observation: I I Noflow
Describe the Industrial ac&Ales occuring within the ougO drebmw arcs.
(A*T&tAL VO4*101M Y*f-b
COLOR- Describe the d color (e4. red, trrowrr, green, blue)and tlnt (e g., Ilght, med(wa, daft
nowti r.Jc.1%, — M6biQK)
ODOR - Describe arty dbUnd odors (e g. gam+ rotten eggs. ? the discharge may ham
K# t✓6
CLARITY - Choose the number that !rest ranlm the ckwft of the where 1 is clew and 10 Is very
doudY-
1 2 3 4 5 6 7 8 10
FLOATWO SOLIDS - Choose the ma nber that best rancho the amount of floating solids In the disdhwas
where 1 is no solidn and 10 le the surface coyared with t]osttng solids
1 2 3 4 5 6 7 8 9 10
SUSPENDED SOLID - Choose the number that !nest ranks the amount of suspended solids M am Asdrarge,
where 1 is no solids and 10 is extrwnety naeddy
1 2 3 4 5 6 7 8 9 10
FOAM /'��
Is thane arty roam on or In the ebm water disdrarge? yes
OIL SHEEN
is there an oil sheen risible on the stun water ? no
EROSION AT OUTFALL Lwji r9 BAK op *944
Is there M erosion at o/ new the vkhft of the outfap? ves o 64-aFs of 6 1,44
List and describe Whey obvious indicators of storMwatsr Nor�E Ai o
tA#T644kc. STDCWl�s D%"Wab 500" LAA 4 &,ODfD 4'U wt£i
eaEA-ft of 6wZF*21- * kt.rres- DAWILoF SMWAVJAjV4 Blur*+ 43
sign mrgy ilkorle)FIC btSCWka&,6s TA TWLS OASW % o
By this signature, I cergty that this report Is accumiD and complete to the best of my Iahowledge:
rsicnawre of Pwmdttee or Desb7sei
Reference Section 1.4.4
n

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO. NCG080000
FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE
DATE: j 2- -7 2011
INSPECTOR:
TIME: 3O
OUTFALL NM
OUTFALL TYPE:
R EWING STREAM: Ol D(qc
SDO- 00
Ll DITCH IPE 11 CHAMVEL
Raw won: I I Flow fi No flow
Describe the industrial activities occurring within the outfail drainage arm.
PuW« t,� (see 5WPPP
COLOR - Describe the dischargeLc-odor (e.g. red, fin, gam, blue)) a}_� Imo, light+ medluny dark).
k pel �+►+i�e..l1 s� 1 l'_q i� ,4h n 0 Jf k � i,7
ODOR - Describe any dh iind odors (e g. gasoline, natter eggs, chtadne) the discharge may have.
* O8vr5
CLARITY - Choose the number that best ranks the clarity of the dschaage, where 1 is cle rand 10 is very
1 2____f5> 4 5 6 7 8 9 10
FLOATMG SOLIDS - Choose the number that best ranks the amour* of floating so6ids in the discharge,
where 1 is no solids and 10 is the surface covered with ficeting sollde.
1 3 4 5 6 7 8 9 10
SUSPENDED SOLIDS - Choose the number that best rardcs the amount of suspended solids in the dim,
where 1 is no solids and 10 lsy muddy.
1 3 4 5 6 7 8 9 10
FOAM
Is there any foam on or in the stonnwater died? yes no
OIL SHEEN
is there an all sheen viable on the stornrwater dl a? m n
EROSION AT OUTFALL
Is thane erosion at or near the v of the ouftg? no
List and describe other obvious Indicators of stormwater pollution:
H LA
By this signature, l certify the# this report is accurate and complete to On best of my knowledge:
(Signature of Pamif lse or
Reference Section 1.4.4-

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO.
Nc-Glwad 61>
FACILITY NAME: Tam
T� p
COUNTY: ORANGE
DATE: I a a I I
INSPECTOR:N __
_5-;TIME: �
OUTFALLNo.
OUTFALL TYPE: j
RECEIVING STREAM: 64
SDO- 00
❑ DITCH )6 PIPE o CHANNEL
SP@ Sinl PPP r Ca -
Flow observation: ❑ Flow No flow
Describe the Industrial activities occurring within the outfall drainage area.
COLOR - Describe the discharge color (e.g. red, brown, green, blue) and tint (e g., light, medium, dark).
ODOR - Describe any distinct odors (e.g. gasoline, rotten eggs, chlorine) the discharge may have.
CLARITY - Choose the number that best ranks the clarity' of the discharge, where 1 is dear and 10 Is very
cloudy.
1 2 3 4 5 6 7 8 9 10
FLOATING SOLIDS - Choose the number that best ranks the amount of floating solids in the discharge,
where i issolids and 10 is the surface covered with floating solids.
1 2 3 4 5 6 7 8 9 10
SUSPENDED SOLIDS - Choose the number that best ranks the amount of suspended solids in the discharge,
where 1 js no solids and 10 is extremely muddy.
1 2 3. 4 5 6 7 8 9 10
FOAM
foam in discharge?
is the any on or the stomtwater yes na
OIL SHEEN
Is there a olll sheen visible on the storinwater discharge? yes o
EROSION AT UTFALL
Is there ang erosion at or near the vicinity of the outfall? yes n
List and describe other obvious indicators of stormwater pollution:
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
of Permiitse or Designee)

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO.
prc Crogcwz-)
FACILITY NAME: T(�o!f- el, W4
0-v w-- o f �
COUNTY: ORANGE
DATE: i p-;Ll I I
INSPECTOR: 01e!awA-,-
TIME: 6- lS Pr--
OUTFALL No.
OUTFALL TYPE: RECEIVING STREAM: LW CO-
SDO- Qua
E7 DITCH )QPiPE 0 CHANNEL S-09e? Crag
Flow observation: EI Flow No flow
Describe the i{ndusblal activities /occurring within the outfali drainage area.
f i�ti 1 6." �j CrSee g-oae?-
COLOR - Describe the discharge color (e.g. red, brown, green, blue) and tint (e.g., light, medium, dark).
ODOR - Describe any distinct odors (e.g. gasoline, rotten eggs, chlorine) the discharge may have.
CLARITY - Choose the number that beat ranks the clarity of the discharge, where 1 is clear and 10 is very
cloudy.
.!/
1 2 3 4 5 6 7 8 9 10
FLOATING SOLIDS - Choose the number that best ranks the amount of floating solids In the discharge,
where 1 Is !,*"ids and 10 is the. surface covered with floating solids.
1 2 3 4 5 6 7 8 9 10
SUSPENDED SOLIDS - Choose the number that best ranks the amount of suspended solids in the discharge,
where 1 is no Ids and 10 is extremely muddy.
1 2 3 4 5 6 7 8 9 10
FOAM
Is there any foam on or in the stormwater discharge? yes o
OIL SHEEN
Is there an oil sheen visible gp the stormwater discharge? yes no'
EROSION AT OUTFALL
Is there any erasion at or near the vicinity of the outfall? yes no
List and describe other obvious indicators of stormwater pollution: •
By this signature, I certify that this report Is accurate and complete to the best of my knowledge:
of Pemrittee or Designee)

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO. FACILITY NAME:
}JCL -spa 6�dr 1-6
COUNTY: ORANGE DATE: 1� 0LI l-1
INSPECTOR: TIME: 4'.s 3 A r.
OUTFALL No.
OUTFALL TYPE:
RECEIVING ST
SDO- pz� 3
c DITCH PIPE 0 CHANNEL
Flow observation: lI Flaw No flow
Describe the industrial actiMes within the ouifall drainage area.
occurring
(4WIW-tft SIT (&a'D
COLOR - Describe the discharge color (e.g. red, brown, green, blue) and tint (e.g.. i% t, medium, dark)_
bra,, �;. 5� /� &' 1�.,�, b.w.
ODOR - Describe any distinct odors (e.g. gasoline, rotten eggs, chlorine) the discharge may have.
CLARITY - C number that best ranks the clarity of the discharge, where 1 is clear and 10 is very
cloudy.
1 2 3 4 5 6 7 S 9 10
FLOATING SgUDS - Choose the number that best ranks the amount of floating solids in the discharge.
where 1 Is solids and 10 is the surface covered with floating solids.
1 2 3 4 5 6 7 8 9 10
SUSPENDED SOLIDS - Choose the number that best ranks the amount of suspended solids in the discharge,
where 1 is no solids and 10 is extremely muddy. " P aVi
1 2 3 4 5 6 7 8 10
FOAM
Is there any foam on or in the stornrwater discharge? yes Qno
OIL SHEEN
Is there an oil sheen visible on the stonnwater discha ? yes no
EROSION AT OUTFALL
Is there any erosion at or near the vlc[nM of the outfall? no
List and describe other obvious Indicators o{f stormwater polluOtion:
/
A"-j �.�.,}� 'J-s
32��
By this signature, I certify that this report Is accurate and complete to the best of my knowledge:
Permitfee our Designee)
e

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO.
PC-a0boMrC0
FACILITY NAME: J-aw-o Cf- C 4PCL--04tL-
�P!r dm"Ruw-s Cs cL
COUNTY: ORANGE
DATE: E 2 al 1 l
INSPECTOR: %ti
TIME: 6 scxo p/..
OUTFALL No. OUT>=ALL TYPE:
RECEMNG STREAW6
SDO-00 + ❑ DITCH tWPIPE 13 CHMINEL
SAS i�PEI j .� N
Flow observation: ❑ Flaw o now
Describe the industrial activities occurring in the ouNail drainage area.
QcAlw,e s6'6 � f QPP>
COLORbe the discharge color (e.g. red, brown, green, blue) and tint (e.g., light, medium, dark).
ODOR - ribs any distinct odors (e.g. gasoline, rotten eggs, chlorine) the discharge may have.
CLARITY - hoose the number that best ranks the clarity of the discharge, where 1 is clear and 10 is very
cloudy.
1 2 3' 4 5 6 7 8 9 10
FILOAfING SQUDS - Choose the number that best ranks the amount of floating solids in the discharge,
1 is solids and 10 is the surface covered with Rwdrtg solids.
kere
1 2 3 4 5 6 7 8 9 10
SPNDED PLIDS - Choose the number that best ranks the amount of suspended solids in the discharge,
where t is solids and 10 is extremely muddy.
1 2 3 4 5 6 7 $ 9 10
FOAM
Is there a foam or in.the stannwater discharge? yes no Is them awl�
OIL SHEEN
Is there an o sheen visible on the stormwater discharge? yes no
EROSION AT OUT L \
Is there any erqMon at or near the vicintty of the outfall? yess (�
List and describe other obvious indicators of stormwater Pollution:
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(SignaWm I&AamWftee or De*nee)

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO. NCG080000
FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE
DATE: h I 12.o01-
INSPECTOR: �,0'(ei,,r
TIME: drop pp,.
OUTFALL No.
OUTFALL TYPE:
RECEIVING SIRE
SDO- bD (
D DlTCH )(PIPE ❑ CHAIVNEI
OLD rile b 4LW-K/rJej NOPLrG
Flow observation: D Flow 'KNo flow
Describe the inckrstrial activities occurring within the ouftall drainage area. "
"T OWS rr (see su+PPe)
COLOR - Describe the discharge color (e.g. red, brown, green, blue) and tint (e.g., light, medium, dark).
I- \
ODOR - be any distinct odors (eg. gasoline, rotten eggs, chlorine) the discharge may have.
CLARITY - C the number that best ranks the clarity of the discharge, where 1 is clear and 10 is very
cloudy.
1 2 3 4 5 6 7 8 9 10
FLOATING SOLIDS - hoose the number that best ranks the amount of floating solids in the discharge,
where 1 is no solids an 10 is the surface covered with floating solids.
2 3 4 5 6 7 8 9 10
SUSPENDED SOLIDS - C the n7umber that best ranks the amount of suspended solids in the discharge,
where 1 is no acids and i0 is ely muddy.
1 2 3 4 5 6 7 8 9 10
FOAM
Is there any foam on.or In the ater discharge? yes 6V
OIL SHEEN
Is there an oil sheers visible on the stonnwater discha ?
EROSION AT OUTFALL
Is there any erosion at or near the vicinfty of the outfall? eQo
List and describe other obvious indicators of stornhwater pollution:
. jo for+.
kAig(L fL4&, _t.or+ A4 6 A+n#4 P*L . Fl4E eorl t!?z Qitlhfd: �P 1Aft Pr
l Ste" W - 00 ftjW A4 u04-
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of NmufW or Designee)
Reference Section 1.4.4
K

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO. NCG080000
FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE
DATE: Izi
INSPECTOR: '�'C% p'
TIME: Ip *gyp
OUTFALL No.
OUTFALL TYPE: RECEMNG ST
S130-Qrp'Z
❑ DITCH iPIPE Cl CHANNEL p4s C.�
Row obsa vation: 0 Flow KNoflow
----\ be the industrial activities occurring within the ouifall drainage area.
P.P. 6S&C-- Swf6i�
COLOR - C67 the discharge color (e.g. red, brown, green, blue) and tint (e.g., light, medium, dark).
ODOR - Describe ny distinct odors (e g. gasoline, rotten eggs, chlorine) the discharge may have.
CLARITY - Choose the umber that best ranks the clarity of the discharge, where 1 Is dear and 10 is very
cloudy.
1 2 3 4 5 6 7 8 9 10
FLOATING SOLIDS - C the number that best ranks the amount of floating solids in the discharge,
where i Is no solids and 10 is surface covered with floating solids.
1- 2 3 4 5 6 7 8 9 10
SUSPENDED SOLIDS - Choose the ber that best ranks the amount of suspended solids in the discharge,
where 1 is no solids and 10 is muddy.
1 2 3 4 5 6 7 8 9 10
FOAM
Is there any foam on or in the stormwate discharge? 'yes
OIL SHEEN
Is there an all sheen visible on the stormwater di e? yes CO—)
EROSION AT OUTFALL
Is then: any erosion at or near the vicinity of the outfall? yes
List and describe other obvious indicators of stormwater pollution:
/VD f-c.oa
By this signature, I certitV that this report is accurate and complete to the best of my knowledge:
(Signature of Pfmfttee or Designee)
Reference Section 1.4.4

FORMA 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO. NCG080000
FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE
DATE: I It av?_
INSPECTOR: D, a ?,jopoe-
TIME: 10' 30 Av-
OUTFALL No.
OUTFALL TYPE:
R_E 94ftC S�
SDO- 06 3
13 DrTCH PIPE 0 CHANNEL
�[�� I.U96 cpwm
Flow observation: 0 Flow No flow
Describe the industrial activities occurring within the outfall drat area
Qw - tkftaft vbtfte• M" (see so"*
COLOR - be the discharge color (e.g. red, brown, groan, blue) and tint (e g., light, medium, dark).
ODOR - Describe a7 odors (e.g. gasoline, rotten eggs, chlorine) the discharge may have.
that
CLARITY - Choose the nu best ranks the clarity of the discharge, where 1 is clear and 10 Is very
cloudy
1 3 4 •5 6 7 $ 9 10
FLOATING SOLIDS - Choose the numb that best ranks the amount of floating solids in the discharge,
where I is no solids and 10 is the surface o with floating solids.
1 2 3 4 5 S 7 8 9 10
SUSPENDED SOLIDS -Choose the number thal best tenure the amount of suspended solids in the discharge,
where 1 is no solids and 10 is extremely muddy.
1 2 3 4 5 7 8 9 10
FOAM
in discharge?
Is there any foam on or the stormwater yes LQ
OIL SHEEN
Is there an oil sheen visible on the stormwater discha e? yes 09
EROSION AT OUTFALL
Is there any erosion at or near the vicinity of the outfall? yes
List and describe other obvious indicators of stormwater pollution:
-- L40 Fw+a — Saa&t Pogo" WAS& tlrl 1& &5ly 6"00 SA+KS,
o fvsfse 5vMacLF5 !e,"6vTr4r._ CRT FStRASS
T
w K k"Od if' f&mej _7 -
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
li>. O
(Signature OrPennfttise or Designee)
Reference Section 1.4.4

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO. NCG080000 FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE D�.j t L0r Z.
INSPECTOR: , Q'(�N.r TIME: I 0
OUTFALL No.
OUTFALL TYPE:
RE
�d��`� 4,W kqw C"A
SDO- Qp4
0 DITCH PIPE ❑ CHANNEL
Flow observation: ❑ Flow Aftflow
Describe the industrial activities ng within the outhdi drainage area.
W. �s>� sine
COLOR - be7 discharge color (e.g. red, brown, green, blue) and tint (e.g., light, medium, dark).
ODOR - Describe R4 distinct odors (eg. gasoline, rotten eggs, chlorine) the discharge may have.
CLARITY - Choose the nran that best ranks the clarity of the discharge, where 1 is clear and 10 is very
cloudy.
1 23 4 5 6 7 8 9 10
FLOATING SOLIDS - Choose the num that best ranks the amount of floating solids In the discharge,
where 1 is no solids and 10 Is the surface with floating solids.
1 2 3 4 5 6 7 8 9 10
SUSPENDED SOLIDS - Choose the number thatbeftranks the amount of suspended solids in the discharge,
where 1 is no solids and 10 is extremely muddy.
1 2 3 4 5 7 8 9 10
FOAM
Is there any foam on or in the stormwater discharge? yes
OIL SHEEN
Is there an oil sheen visible on the stormwater d e?
EROSION AT OUTFALL
Is there any erosion at or near the vicinity of the outfall? yes
List and describe other obvious indicators of stormwater pollution:
do F"r►
By this signature,II certify
thatt this report is accurate and complete to the best of my knowledge:
(Signature of Pinn tee or Designee)
Reference Section 1.4.4

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO. NCGO80000
FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE
DATE: a7
INSPECTOR:'. ' Q'cf
TIME:
OUTFALL No.
OUTFALL TYPE:
RQE EE1f1'G TR,$AM:
SDO- OV 1
❑ DITCH 7kPIPE 0 CHANNEL
G
Flow observation: ❑ Flow No flow
Describe the industrial activities occurring within like outfall drainage area.
TV-G-rss V- q*-4 L'/ cs-'e- S.WPeg)
COLOR s 'be the discharge color (e.g. red, brown, green, blue) and tint (e g., light, medium, dark).
ODOR - Des"be any distinct odors (e g. gasoline, rotten eggs, chlorine) the dhwharge may have.
CLARITY - Ch the number that best ranks the clarity of the discharge, where 1 Is clear and 10 is very
dourly.
2 3 4 5 6 7 8 9 10
FLOATING SOLIDS - Choose t—he—nmokew that best ranks the amount of floating solids in the discharge,
where 1 is no solids and 10 Is the surface with floating solids.
1 2 3 4 5 6 7 8 9 10
SUSPENDED SOLIDS -Choose the number that ranks the amount of suspended solids in the discharge,
where 1 is no solids and 10 is extremely muddy.
1 2 3 4 5 6 7 8 9 10
FOAM
foam in the discharge.
Is there any on or stormwater yes
OIL SHEEN
Is there an oil sheen visible on the stormwater discharge?
EROSION AT OUTFALL
a
Is there anv erosion at or new the vicinity of the outtall? yes
List and describe other obvious Indicators of stormwater polluti
5'W 3T .
&yy f
li.r2�
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
of PemVffw or Designee)
Reference Section 1.4.4

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO. NCG080000
FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE
DATE: 2 la7
INSPECTOR: aft
TIME:pr-
OUTFALL No.
OUTFALL TYPE:
RECEIVING STREAM,
SDO- � �
❑ DITCH iPE D CHANNEL
0� �
I
Flow observation: fJ Flow No ftow
Describe the indusjtrial activities occurring within the outf�alldral area
COLOR - D97 discharge color (e.g. red, brown, green, blue) and tint (e.g., light, medium, dark).
ODOR - Describe any nct odors (e.g. gasoline, rotten eggs, chlorine) the discharge may have.
CLARITY - Choose the num best ranks the clarity of the discharge, where 1 is dear and 10 Is verycloudy.
.
1 2 3 4 5 6 7 8 9 10
FLOATING SOLIDS - Choose the nu that best ranks the amount of floating solids in the dish,
where 1 is no solids and 10 is the Buda covered with floating solids.
1 2 3 5 6 7 8 9 10
SUSPENDED SOLIDS - Choose the number best ranks the amount of suspended solids in the discharge,
where 1 is no solids and 10 is extremely mud .
1 2 3 4 6 7 8 9 10
FOAM
Is there any foam on or in the stormwater discharge? yes 6?
OIL SHEEN
Is there an oil sheen visible on the stormwater discha e? yes cre'
EROSION AT OUTFALL
Is there any erosion at or near the vicinity of the outfall? yes
List and describe other obvious Indicators of stormwater pollution:
i V'4 AFL. '
By this signature, I certify that this report Is accurate and complete to the best of my knowledge:
(Signature of Penb&6e or Designee)
Reference Section 1.4.4

FORK[ 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO. NCGO80000 FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE DATE: a� IdL
INSPECTOR: , 6 �N � TIME: 3c • Pr^
OUTFALL No.
OUTFALL TYPE:
RECEIYING STREAM:
SDO- 60-2,
f7 i3fTCFf PIPE U CHANNEL
� AL
Flow observation: U Flow No flow
Describe the industrial activities occurringwithinwitthin thecoutfall drainage
COLOR - Describe the discharge color (e.g. red, brown, green, blue) and tint (e.g., light, medium, dark).
ODOR - Describe any dish odors (eg. gasoline,'rotten eggs, chlorine) the discharge may have.
CLARITY - Choose the number that the clarity of the discharge, where 1 is clear and 10 is very
cloudy:
1 2 3 4 5 6 7 8 9 10
FLOATING SOLIDS - Choose the number that ranks the amount of floating solids in the discharge,
where 1 is no solids and 10 is the surface co with floating solids.
1 2 3 45 6 7 8 9 10
SUSPENDED SOLIDS - Choose the number that best rain amount of suspended solids in the discharge,
where 1 Is no solids and 10 is extremely muddy.
1 2 3 4 5 6 7 8 9 10
FOAM
Is there any foam on or in the stonnwater discharge? yes
OIL SHEEN
Is there an oil sheen visible on the stormwater disc e? yes HC)
EROSION AT OUTFALL AxT -!
Is there any erosion at or near the vicingy of the outfali? no a " Q 5
List and describe other obvious indicators of stormwater pollution:
By this signature, I certify that this report is accurate and compiete to the best of my knowledge:
M
(Signature em ose or Designee)
Reference Secfion 1.4.4
0

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO. NCG080000
FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE
DATE: a-7
INSPECTOR: , C31(d,,,,,,�
TIME: J-c IS-
OUTFALL Na.
OUTFACE TYPE:
6 t �NRGM
SDO- Gp ¢
Cl DITCH IPE r_t CHANNEL
Flow observation: 0 Flow No flow
Describe the industrial activities occurring withln outfail drat
P Woe-[�-s C� � S wQ�.
COLOR - Descri 7ischarge color (e.g. red, brown, green, blue) and tint (e.g., light, medium, dark).
ODOR - Describe any dl odors (eg. gasoline, rotten eggs, chlorine) the discharge may have.
CLARITY - Choose the number best ranks the clarity of the discharge, where 1 is dear and 10 is very
cloudy.
1 2 3 4 5 6 7 8 9 10.
FLOATING SOLIDS - Choose the number best ranks the amount of floating solids in the discharge,
where 1 is no solids and 10 is the surface with floating solids.
1 2 3 4 6 7 8 9 10
SUSPENDED SOLIDS -Choose the number that best, amount of suspendedsolids in the discharge,
7nkshe
where 1 is no solids and 10 is extremely muddy.
1 2 3 4 57 8 9 10
FOAM
Is there any foam on or in the stormwater discharge? yes no
OIL SHEEN
Is there an ail sheen visible on the stormwater discharge? yesn
EROSION AT OUTFALL
Is there any erosion at or near the vicinity of the outfall? yes
List and describe other obvious indicators of stormwater pollution:
o gUcc`r�n
r
By this signature, I certify that this report is accurate and complete to the best of my iknowiedge:
(Signature of Pe or Designee)
Reference Section 1.4.4

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO. NCG080000
FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE
DATE: r; I -a—
INSPECTOR: ,
TIME:�►r-
OUTFALL No.
OUTFALL TYPE:
RECEIVING STREAM•
SDO- OV
0 DITCH IPE ❑ CHANNEL
�� i te E C
Flow observation: 0 Flow No flaw
Describe the industrial activities occurring n the outfall drat area.
�'s-�
COLOR - Deqribe the discharge color (e.g. red, brown, green, blue) and tint (e.g., light, medium, dark).
ODOR - Describe an' odors (eg. gasoline, rotten eggs, chtorine) the discharge may have.
CLARITY - Choose the num than best ranks the clarity of the discharge, where 1 is clear and 10 is very
cloudy.
1 2 3 4 5 6 7 8 9 10
FLOATING SOLIDS - Choose the nunh that best ranks the amount of floating solids in the discharge,
where 1 is no solids and 10 is the surface with floating solids.
1 2 3 5 6 7 8 9 10
SUSPENDED SOLIDS - Choose the number that ranks the amount of suspended solids In the discharge,
where 1 Is no solids and 10 is extremely muddy.
1 2 3 4 5 7 8 9 10
FOAM
Is there any foam on or in the stormwater discharge? yes no
OIL SHEEN
Is there an oil sheen visible on the storrawater dische ?—"a
EROSION AT OUTFALL
Is there any erosion at or near the vicinity of the outfall? yes no
List and describe other obvious Indicators of stormwater poW ion:
0 -F� Po 1j'3> Fuca C'K 5r§1*
' ft-0�1 L� 4q--r I C - g
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
i
(Signature of Amfifme or Deogrnee)
Reference Section 1.4.4

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
{QUALITATIVE MONITORING REPORT
NPDES PERMIT NO. NCGO80000
FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE
DATE: o2
INSPECTOR: V
T1ME: �; Zee � ram•
OUTFALL No.
OUTFALL TYPE:
REC NG STAM
SOO- Q0'2
❑ DITCH IPE ❑ CHANNEL
���
Flow observation: ❑ Flow o flow
Describe the industrial activities occuning within the outfafl —"---area.
COLOR - De7 discharge color (e.g. reed, brown, green, blue) and tint (e.g., light, medium, dark).
ODOR - Describe an'7 odors (eg. gasoline, rotten eggs, chlorine) the discharge may have.
CLARITY - Choose the num tthat best ranks the clarity of the discharge, where 1 is ear and 10 is very
dowdy.
1 2 3 4 - 5 6 7 8 9 10
FLOATING SOLIDS - Choose the be r that best ranks the amount of floating solids in the discharge,
where 1 is no solids and 10 Is the covered with floating solids.
1 2 3 4 5 6 7 8 9 10
SUSPENDED SOLIDS - Choose the number best ranks the amount of suspended solids in the discharge,
where i is no solids and 10 is extremely m
1 2 3 4 6 7 8 9 10
FOAM
is there any foam on or In the stormwater discha ? yes no
OIL SHEEN
Is there an oil sheen visible on the stormwater discha\rgO M 4 n
EROSION AT OUTFALL
Is there any erosion at or near the vicinity of the outtall? Ves Cno
List and describe other obvious indicators of stormwater pollution:
"0
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of P itfes or Designee)
Reference Section 1.4.4

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO. NCGO80000
FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE
DATE: 4616)19.
INSPECTOR: O p%Kor
TIME:
OUTFALL No.
OUTFALL TYPE:
REC NG SbTREAM-
SDO- 0 3
L] DITCH �iPIPE O CiiANNEL
nru
Flow observation: ❑ Flaw No flow
Describe the industrial activities occurring within the outfall drainage area.
1-MA kjtf-4 i - Sm%A*,5
COLOR - = discharge color (e.g. red, brown, green, blue) and tint (e.g., light, medium, dark).
ODOR -Describe any net odors (e.g. gasoline, n>tten eggs, chlorine) the discharge may have.
CLARITY - Choose the numbs best ranks the clarity of the discharge, where 1 is clear and 10 is very
cloudy.
1 2 3 4 5 6 7 8 9 10
FLOATING SOLIDS - Choose the nu m that best ranks the amount of floating solids In the discharge,
where 1 is no solids and 10 Is the surface with floating solids.
1 2 3 5 6 7 8 9 10
SUSPENDED SOLIDS - Choose the numberFOest ranks the amount of suspended solids in the discharge,
where 1 is no solids and 10 Is extremely muy.
1 2 3 5 6 7 $ 9 10
FOAM
Is there any foam on or in the stormwater discharge? yes no
OIL SHEEN
Is there an all sheen visible on the stormwater discharge?
EROSION AT OUTFALL A915V 06 C3AsI,5 q-
Is there any erosion at or near the vicinity of the outfall? jig =no J
List and describe other obvious Indicators of stormwater pollution: "t a
0 V-L-O-"j j &-t^ZLeq- C5MIsr t
( rs 6 s rr� �'�cr�` 11a ► 4 SPtLt
L�,A-rkj VrK c;{ cOmp'tVth C11 gQtQ�`
- �C 'A��WN 11 1
By this signature, i certify th,
(Sigrzatune of
Designee)
retort is accurate and complete to the best of my knowledge:
Reference Seciffon 1.4.4
1
V

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO. NCG080000 FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE DATE: E, 1;t-
INSPECTOR: O)o,..�V rL TIME: 6 " f 5' P c'--
OUTFALL No.
OUTFALL TYPE:
RECEIVING STREAM:
SDO- 63o ¢
❑ DITCH PIPE p CHANNEL
Flow observation: ❑ Flow No now
rat a area.
Describe the industrial activities occurring within the outf dl drains
PL&su C ag-KS �m,?ue�c CSEE SW fQP
COLOR the discharge color (e.g. red, brown, green, blue) and tint (e g., light, medium, dark).
ODOR - Describe distinct odors (e.g. gasoline, rattan eggs, chlorine) the discharge may have.
CLARITY - Choose the n that best ranks the clarity of the discharge, where 1 is clear and 10 is very
cloudy.
1 2 3 4 5 6 7 8 9 10
FLOATING SOLIDS -Choose the ber that best ranks the amount of floating solids in the discharge,
where 1 Is no solids and 10 is the covered with floating solids.
1 2 3 4 5 6 7 8 9 10
SUSPENDED SOLIDS - Choose the number best ranks the amount of suspended solids in the discharge,
where i is no solids and 1a is extremely mu
1 2 3 4 6 7 8 9 10
FOAM
Is there any foam on or in the stormwater discha ? yes no
OIL SHEEN
Is there an oil sheen visible on the stormwater discharge? yes no
EROSION AT OUTFALL
Is there any erosion at or near the vicinity of the outtall? yes no
List and describe other obvious indicators of stormwater pollution:
- (I o k--L4'4 A-R-- 04-q`EN�5
_ _ -
t rJ 4 MA-L. ed Nil OZ- l t-S Q N S , PJ
By this signature, I certify that this report Is accurate and complete to the best of my knowledge:
'�� d
(Signature o! Pe or Designee)
Reference Section 1.4.4

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO. NCG080000
FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE
DATE: $ 6 a.pI
INSPECTOR: i , D'G, -,- 11
TIME: j► ,cxa et--
OUTFALL No.
OUTFALL TYPE:
RECEIVING STREAM:
SDO-
❑ DITCH 1APIPE ❑ CHANNEL
UI�D�F � F
Flow observation: ❑ Flow Q No flow
Describe the industrial activities occurring within the oultall drainage arm.
_MA14S tT 'Fjl7r--I L(T_'j (S Ef SW PPP
COLOR - D97 the discharge color (e.g. red, brown, green, blue) and tint (e.g., light, medium, darn).
ODOR - Describe 7isfinct odors (e.g. gasofine, rotten eggs, chlorine) the discharge may have.
CLARITY - Choose the umber that best ranks the Clarity of the discharge, where 1 Is clear and 10 is very
cloudy.
7 2 3 4 5 6 7 8 9 10
FLOATING SOLIDS - C the number that beat ranks the amount of floating solids In the discharge,
whom 1 Is no solids and 10 is surface covered with floating solids.
1 2 3 4 5 6 7 .8 9 10
SUSPENDED SOLIDS - Choose the umber that best ranks the amount of suspended solids In the discharge,
where 1 is no solids and 10 Is extrem y muddy.
1 2 3 4 5 6 7 8 9 10
FOAM
Is there any foam on or in the sto discharge? yes no
OIL SHEEN
Is there an oil sheen visible on the stormwate discha ? yes no
EROSION AT OUTFALL
Is there any erosion at or near the vicinity of the II? es no
List and describe other obvious Indicators of stormwater pollution:
o .uA-� Rt�-*W t.'-P A$` k_
C6119*�' {`6T- kZAEF_$S CA"WV EIS rTM melt ---
By this signature, I certify that this report Is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
Reference Section 1.4.4

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO. NCGO80000
FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE
DATE: OL )-nla
INSPECTOR: `1J,p'(�n�,dC
TIME: ; 15 Pry
OUTFALL No.
OUTFALL TYPE: RECEIVING STREAM
SDO- Doi
❑ DITCH �QIPE ❑ CHANNEL &-b IF(w C�i�
Flow observation: ❑ Flow rX No flow
Describe the industrial activities occurring within the outfell d mega arm.
P u BL-I C (�l1ay-s `oM Pt�G c��6E S w�e
COLOR - 'be the discharge color (e.g. red, brown, green, blue) and tint (e.g., light, medium, darkr
ODOR - Describe a distinct odors (eg. gasoline, rotten eggs, chlorine) the discharge may have.
CLARITY - Choose the nu that best narks the clarity of the discharge, where 1 is dear and 10 is very
cloudy.
1 3 4 5 6 7 8 9 10
FLOATING SOLIDS - Choose the umber that best ranks the amount of floating solids in the discharge,
where 1 is no solids and 10 is the covered with floating solids.
1 2 4 5 6 7 8 9 10
SUSPENDED SOLIDS - Choose the nu that best ranks the amount of suspended solids in the discharge,
whom1 is no solids and 10 Is extremely m y.
1 2 3 4 5 6 7 8 9 10
FOAM �l
Is there any foam on or in tits stormwater di e? yes ( i7M
OIL SHEEN
Is there an all sheen visible on the storrnwater disc ? yes o
EROSION AT OUTFALL
Is there any erosion at or near the vicin' of the outfall? yes no
List and describe other obvious indicators of stormwater pollution:
OVUl�W
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of P&4n&We or Designee)
Reference Section 1.4.4

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO. NCGO80000
FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE
DATE: t3g 90 is -
INSPECTOR: b. p aNlae
TIME: I i ti 3 a f r,-- — 12 :o 6
OUTFALL No.
OUTFALL TYPE:
RECEIVING STREAM:
SDO- DO 3
n DITCH HIPE 0 CHANNEL
OLJ"> H per '
Flow observation: 0 Flow No flow
Describe the industrial activities occurring within the oudall drainage area.
M -[A-L S"9--� 1140 f. -
COLOR - Des7 discharge color (e-g- red, brown, green, blue) and tint (e.g, Ilght, medium, dark).
ODOR - describe a distinct odors (e.g. gasoline, rotten eggs, chlorine) the discharge may have.
CLARITY - Choose the nu bar that best ranks the clarity of the discharge, where 1 is dear and 10 is very
cloudy.
1 3 4 5 6 7 8 9 10
FLOATING SOLIDS - Choose number that best ranks the amount of floating solids in the discharge,
where 1 is no solids and 10 is the rface covered with floating solids.
1 2 3 4 5 6 7 8 9 10
SUSPENDED SOLIDS - Choose tlhe rhu ber that best ranks the amount of suspended solids in the discharge,
where 1 Is no solids and 10 is ehnremely uddy.
1 2 3 4 5 6 7 8 9 10
FOAM
Is there any foam on or in the stonnwat�"arge? yes no
OIL SHEEN
Is there an oil sheen visible on the stormwatOr isc e? yes no
EROSION AT OUTFALL
Is there any erosion at or near the vicinity of the outfall? no
List and describe other obvious indicators of stormwater pollution:
au---"FAu
By this signature, I cer
t
ify that this report is accurate and complete to the best of my knowledge:
{Signature of Permfte or Designee)
Reference Section 1.4.4

FORM 5
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
NPDES PERMIT NO. NCG080000
FACILITY NAME: TOWN OF CHAPEL HILL
TOWN OPERATIONS CENTER
COUNTY: ORANGE
DATE: 8 ='?-
INSPECTOR: b , 0'ao,3�
TIME: ).';I : ov .
OUTFALL No.
SDO- / -
OUTFALL TYPE:
0DITCHXrE 0 CHANNEL
REEC�,, VllSTREAM;
Flow observation: ❑ Flow No flow
Describe the Industrial activities occurring within the outfall drainage area.
pvsu� woq�y--s coig(&c
COLOR - Descri7discharge color (e.g. red, brown, green, blue) and tint (e.g., light, medium, dark).
ODOR - Describe a lstinct odors (e g. gasoline, rotten eggs, chlorine) the discharge may have.
CLARITY - Choose the n best ranks the clarity of the discharge, where 1 is clear and 10 is verycloudy.
717
3 4 5 B 7 8 9 10
FLOATING SOLIDS - Choose the umber that best ranks the amount of floating solids In the discharge,
where 1 is no solids and 10 is the cc covered with floating solids.
1 2 3 4 5 6 7 8 9 10
SUSPENDED SOLIDS - Choose the num that best ranks the amount of suspended solids In the discharge,
where 1 is no solids and 10 Is extremely m dy.
1 2 3 4 5 6 7 8 9 ip
FOAM
Is there any foam on or in the stormwater di arge? yes no
OIL SHEEN
Is there an oil sheen visible on the stormwater di e? yes no
EROSION AT OUTFALL
Is there an erosion at or near the vicln at the outfall? no
List and describe other obvious indicators of stornrwater pollution:
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
�>' 91, t/
(Signature colermittee or Designee)
Reference Section 1.4.4

4
h
NONSTORMWATER DISCHARGE ASSESSMENT FORM 3
NONSTORMWATER DISCHARGE ASSESSMENT
Facility: Town of Chapel Hill — Public Works Complex and Transit Facil
Inspector. Daniel J. O'Connor Date: May 5-6. 2010
Outfall Directly Observed
Method Used to Test
Describe Results from Test
identify Potential
Name of Person Who
Date of Test or
During the Test (identify as
or Evaluate Discharge
for the Presence of Non-
Significant Sources
Conducted the Test or
Evaluation
indicated on the site map)
Stormwater Discharge
Evaluation
May 5.6, 2010
SDO-001
Plan review,
No Evidence
See Site Plan, SWPPP
D. O'Connor
Observation, Interview
narrative
Steam cleaning of large
Evidence of pavement
buses is performed such
staining and oily residue
that cleaning operations
May 5-6, 2010
DA-OC 1
Observation, Interview
being discharged to storm
occur partially outdoors
D. O'Connor
system outside southeast
(possibly due to large size of
comer of Transit Building
buses
Evidence of pavement.
Leaks and drips from buses,
May 5-0, 2010
DA-OC 1
Observation
staining on ground around
and possible overspray from
D. O'Connor
the Transit Fuel Dispensing
cleaning buses
Area
Minor pavement stains in the
Leaks and drips from buses
May 5-6, 2010
DA-001
Observation
large Bus/Van/Service
and other vehicles parked
D. O'Connor
Vehicle Parking Lot
on -site
May 5-6,2010
SDO-002
Plan review,
Observation, Interview
No Evidence
See Site Plan, SWPPP
narrative
D. O'Connor
Illicit Discharge to Storm
Salt and sandlsak mixture
May 5-0. 2010
DA-002
Observation
Salt and salttsand mixture
residue discharging into
escaping nearby Covered
D. O'Connor
storm drain inlet
Sand/ Salt Storage Shed
Staining present on
pavement beneath two open
Rust from metal dumpsters
May 5-0, 2010
DA-002
Observation
yard waste dumpsters (no
and yard waste residue
D. O'Connor
lids) stored west of Pole
Bam 2
Reference Section 1.4.5

NONSTORMWATER DISCHARGE ASSESSMENT FORM 3
NONSTORMWATER DISCHARGE ASSESSMENT
Facility: Town of Chapel Hill —Public Works Complex and Transit Facility
Inspector: Daniel J. O'Connor Date: May 5-6, 2010
Outfall Directly Observed
Method Used to Test
Describe Results from Test
Identify Potential
Name of Person Who
Date of Test or
During the Test (identify as
or Evaluate Discharge
for the Presence of Non-
Significant Sources
Conducted the Test or
Evaluation
indicated on the site map)
Stormwater Discharge
Evaluation
Rusted solid waste dumpster
with rust residue on ground
Rust from metal dumpster
May 5-6, 2010
DA-002
Observation
(no lid) stored west of
and solid waste leachate
D. O'Connor .
Covered Spreader Storage
Shed
Allowable NonSton-nwater
Discharge — Condensate
Ice Machine condensate line
May 5-6. 2010
DA-002
Observation
from Ice Machine
discharging to ground
outside of Operations
D. O'Connor
surface outside east side of
Building
Operations Building
May 5 6, 2010
5D0-003
Plan review, Interview,
No Evidence
See Site Plan, SWPPP
D. O'Connor
Observations
narrative
Some litter present at outfall
May 5-6, 2010
SDO-004
Plan review, Interview,
(end of pipe from stormwater
Sanitation Truck Parking
D. O'Connor
Observations
basin north of Sanitation
Area
Truck Parking Area)
Leaks observed from
Leaks and drips occurring
sanitation vehicles; evidence
from Sanitation Trucks
of excessive pavement
parked along fence line;
May 5-6, 2010
DA-004
Observation
staining beneath and around
the sanitation vehicles
fluids and litter is escaping
D. O'Connor
parked on -site; litter
the open back ends of
observed all along the fence
Sanitation Trucks
line behind sanitation trucks
discharging to storm system
Reference Section 1.4.5

NONSTORMWATER DISCHARGE ASSESSMENT FORM 3
NONSTORMWATER DISCHARGE ASSESSMENT
Facility: Town of Chagel Hill — Public Works Complex and Transit Facility
Inspector: Daniel J. O'Connor Date: May 5.6, 2010
Outfall Directly Observed
Method Used to Test
Describe Results from Test
Identify Potential
Name of Person Who
Date of Test or
During the Test (identify as
or Evaluate Discharge
for the Presence of Non-
Significant Sources
Conducted the Test or
Evaluation
indicated on the site map)
Stormwater Discharge
Evaluation
Erosion is occurring in
Slope is not stabilized along
May 5-6, 2010
DA-004
Observation
several areas along the
slope and fence line
fence line and southern
D. O'Connor
northeast of PW Truck Wash
edge of stormwater basin
Building
May 5-6, 2010
DA-004
Observation
basin open (missing lid) None detected, but catch
Sediment transport
D. O'Cannar
Reference Section 1.4.5

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins. Director
Division of Water Quality
October 30, 2007
Mr. Roger Stancil
Town of Chapel Hill
405 Martin Luther King Jr. Blvd.
Chapel Hill, NC 27514
Subject: General Permit No. NCG080000
Chapel Hill Municipal Operations
COC No. NCGO80800
Orange County
Dear Mr. Stancil:
In accordance with your application for a discharge permit received on July 30, 2007 we
are forwarding herewith the subject certificate of coverage (COC) to discharge under the subject
state — NPDES general permit. This permit is issued pursuant to the requirements of North
Carolina General Statute 143-215.1 and the Memorandum of Agreement between North Carolina
and the US Environmental Protection Agency dated May 9, 1994 (or as subsequently amended).
Please take notice that this certificate of coverage is not transferable except after notice to
the Division of Water Quality. The Division of Water Quality may require modification or
revocation and reissuance of the certificate of coverage. This permit does not affect the legal
requirements to obtain other permits whiclfmay be required by the Division of Water Quality or
permits required by the Division of Land Resources, Coastal Area Management Act or any other
federal or local governmental permit that may be required.
If you have any questions concerning this permit please contact Aisha Lau at telephone
number [phone] ext. 578.
Sincerely,
IL P
Coleen H..Sullins
cc: Raleigh Regional Office
Central Files
Stormwater Permitting Unit Files
Attachments
N"o �`ttCarolina
,Naiura!!y
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone [phone] Customer Service
Internet h2o.enrstate.nc.us 512 N. Salisbury St, Raleigh, NC 27604 FAX [phone]
An Equal OpportunitylAffimrative Action Employer— 50% Recyded/10 % Post Consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
- GENERAL PERMIT NO. NCGO80000
CERTIFICATE OF COVERAGE No. NCG080800
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
Town of Chapel Hill
is hereby authorized to discharge stormwater from a facility located at
Chapel Hill Municipal Operations
6850 Mill House Road
Chapel Hill
:Orange County
to receiving waters designated as Old Field Creek, class C NSW water, in the Cape Fear.River Basin in accordance
with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, III, IV, V and VI
of General Permit No. NCGO80000 as attached.
This certificate of coverage shall become effective November 1, 2007.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day October 30, 2007.
/S,V- Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

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Latitude: 35*5526" Chapel Hill Municipal Facility
Longitude: 79 04 33 Operations. p`
�� Location
County:. Orange
Stream Class: C NSW Receiving Stream: Old Field Creel
Sub -basin: 03-06-05 (Cape Fear River Basin) Not scaled

[Fwd: Seeking approval for issuance of Town of Cary's NCGO80798...
t
t R
Subject: [Fwd: Seeking approval for issuance of Town of Cary's NCG080798, and Town of
Chapel Hill's NCG080800]
From: Shannon Langley <[e-mail]>
Date: Wed, 15 Aug 2007 10:19:30 -0400
To: Autumn Hoban <[e-mail]>, Judy Garrett
<[e-mail]>
CC: Aisha Lau <[e-mail]>
Please provide a response to Aisha.
Thanks
Shannon
-------- Original Message --------
Subject: Seeking approval for issuance of Town of Cary's NCGO80798, and Town of
Chapel Hill's NCG080800
Date: Tue, 14 Aug 2007 14:51:08 -0400
From: Aisha Lau <[e-mail]>
To: Shannon Langley <[e-mail]>
Howdy Shannon,
I hope that all is well with you.
When you get the chance would you please review these NOIs yourself or pass them on
to the appropriate person/people for approval? In addition to the table below I've
also attached scanned copies of the NOIs for review.
If I could hear back from you, or one of your RRO coworkers about the applicability
of the permits for these sites by *Friday, September 14, 2007 *I would much
appreciate it. If I don't hear back from someone regarding them by that date I'll
issue them with your assumed approval.
COC I
Facility
Location
City
NCGO80798 Town of Cary Fleet Maintenance Facility
400 James Johnson Avenue
Cary
NCGO80800
Chapel Hill Municipal Operations
6850 Mill House Road
Chapel Hill
Thank you for your help, and if you have any questions don't hesitate to ask.
Enjoy the rest of your summer,
Aisha
Aisha Lau N.C. Division of Water Quality Stormwater Permitting Unit 1617 Mail
Service Center Raleigh, NC 27699-1617
Phone. [phone] ext. 578 Fax: [phone] email: [e-mail]
Website: http://h2o.enr.state.nc.us/su/stormwater.html
Never doubt that a small group of thoughtful, committed citizens can change the
world; indeed, it's the only thing that ever has. Margaret Mead
d of 2 9/24/2007 9:04 AM

[Fwd: Seeking approval for issuance of Town of Cary's NCG080798...
S
08-14-2007(4).pdf
Content -Type: application/pdf
Content -Encoding: base64
,08-14-2007(5).pdf I Content -Type: application/pdf
Content -Encoding: base64
2 of 2 9/24/2007 9:04 AM

40 Division of Water Quality / Water Quality Section
ii- A.
NCDENRNational Pollutant Disebalrge Elimination System
Iky+M U�.r.. �rs+•ar+rcr,r or
NCG080000
NOTICE OF INTENT
FOR AGENCY USE ONLY
Date Received
Year
I Month
I Dav
07
ertiricate of Covers e
NICIMoIX1612�1
Check iF A ount
I
Permit Assigned to
National Pollutant Discharge Elimination System application for coverage under General Permit
NCGO80000:
STORMWATER DISCHARGES from Vehicle Maintenance Areas (including vehicle rehabilitation .
mechanical repairs, painting, fueling, lubrication and equipment cleaning operations areas) as,
tedc-__
'
with activities classified as:
7s r
s1
SIG 40 Rail Transportation
SIC 41 Local and Suburban Transit and Interurban Highway Passenger Transportation
R'
SIC' 42 Motor Freight Transportation and Warehousing (except SIC 4221-4225)
SIC' 43 Postal Service
The following activities are also included:
• Other industrial activities where the vehicle maintenance area(s) is the only area requiring permitting
• Petroleum Bulk Stations and Terminals (SIC 5171) with total petroleum site storage capacity of less than 1
million gallons
• Stormwater discharges from oil water separators and/or from secondary containment structures
associated with petroleum storage facilities with less than 1 million gallons of total petroleum site storage
capacity.
• Discharges associated with vehicle maintenance operations at activities, which are otherwise designated
on a case -by -case basis as being required to be permitted.
(Please print or type)
1) Mailing address of owner/operator:
" Standard Industrial Classincation Code
Name =Cc2" 0 CIE. r �+jNq .Ili t-i,3C _ - tom. rt,.x : (z 11U.'i te
Street Address 5'0C_=1 t�:& Agxir l 1Lt is 6 �ti fl
City et-wPI I. 1+11=6 - State K_Q ZIP Code ?
Telephone No. q 1'! q, L. Fax: q 101 C 1n ' -7 1) to ?.•
Address to which all permit correspondence will be [nailed
2) Location of facility producing discharge:
Facility Name T= 'PeT7 :L rei}�� A t4 j, C:'m .
Facility Contact rr rjr,zr
Street Address
cityState t,,, t_ ZIP Code ?_151
County a-
Telephone No. �� �fi - r, y ray Fax: A 101 9 3 2 - 4 9 1"� l
3) Physical Location Information:
Please provide a narrative description of how to get to the facility (use street names, state r?ad numbers and
N C. - +} w i7(,
distance and direction from a roadway intersection). 2�- - J�iT y� j _oT� _MJAh)
as";o+j- U tJ _ Ev lt,Rw� }LS — } t. t) t.E
(A copy of a county map or USGS quad sheet with facility clearly located on the map is required to be submitted with this application)
r Art i s~t n A r7. F v N) -rt_f � r� C-E t 1 �5 u S T l� �Ui
Page 1 of 3
SWU-223-101701

NCGO80000 N.O.I.
4) This NPDES Permit Application applies to which of the following:
12( New or Proposed Facility Date_ operation is to begin
❑ Existing
S} Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: I G jk 1 7
6) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: _ L1 t- L:A A- __*jj/ A, T j),'t
2 e" '�, r,
7) Discharge points l Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the properly?
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
discharges end up in? /)L T2 t~ i i5y 17 CRe_F_�K Ht-,F ! f1F-
If the site stormwater discharges to a separate storm sewer system, name the operator of the separate storm
sewer system (e.g. City of Raleigh municipal storm sewer).
8) Does this facility have any other NPDES permits?
YNo
❑ Yes
If yes, list the permit numbers for all current NPDES permits for this facility:
9) Does this facility have any Non -Discharge permits (ex: recycle permits)?
YN0
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
10) Does this facility employ any best management practices for stormwater control?
�te s
If yes, please briefly describe:"���+� awfir�sanou (�N1?4 - Cam, v✓L�r-��►-srtc�N-- �t�o#r;
11) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
WYes F OR O�.:tP ? rN(, f i i71v�
If yes, when was it implemented?
(lzcF 'Pcttmm' * NGr_oco'�_q I)
VJor t—JEA4 FR c_i t.r F ! o N k.- = 5 a. 1$ HVT%,&
12) Are vehicle maintenance activities occurring at this facility?
❑ No ER/Yes .
13) Hazardous Waste:
a) IstNs facility a Hazardous Waste Treatment. Storage, or Disposal Facility?
M No 0 Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
E� No ❑ Yes
Page 2 of 3
SWU-223-101701

NCGO$0000 N.O.I.
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
® No ❑ Yes
d) If you answered yes to questions b, or c., please provide the following information:
Type(s) of waste:
Now is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport i disposal vendor:
Vendor address:
14) Certification:
North Carolina General Statute 143-215.6 b (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, -
plan or other document filed or required to be maintained under Article 21 or regulations of the Environmental
Management Commission implementing that Article, or who falsifies, tampers with or knowingly renders inaccurate any
recording or monitoring device or method required to be operated or maintained under Article 21 or regulations of the
Environmental Management Commission implementing that Article, shall be guilty of a misdemeanor punishable by a
fine not to exceed $10,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C- Section 1001 provides
a punishment by a fine of not more than $10,000 or imprtsmment not more than 5 years, cr both, for a similar offense.)
I hereby request coverage under the referenced General Permit. I understand that coverage under this permit
will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
I certify that I am familiar with the information contained in this application and that to the best of my knowledge
and belief such information is true, complete, and accurate.
Printed Name of Person Signing: 12 ur? - 'r
Title: ---
(Signature of Applicant) (Date Signed)
Notice of Intent must be accompanied by a check or money order for $80.00 made payable to:
NCDENR
Final Checklist
This application will be returned as incomplete unless all of the following items have been included:
a Check for $80 made payable to NCDENR
D"' This completed application and all supporting documents
B" Copy of county map or USGS quad sheet with location of facility clearly marked on map
Mail the entire package to:
Stormwater and General Permits Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
Page 3 of 3
SWU-223-101701

*Nfm fpiciwrl
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