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Home My WebLink AboutNCG100130_MONITORING INFO_20180911STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. IV CC, 10,9 3 (� DOC TYPE ❑HISTORICAL FILE �( MONITORING REPORTS DOC DATE ❑ �,qol$o� /I YYYYMMDD CERTIFICATE OF COVERAGE NO. NCG10013 0 FACILITY NAME Liverman's Automotive, Inc. PERSON COLLECTING SAMPLE(S) Allen Liverman CERTIFIED LABORATORY(S) Lab # 314 Part A: Stormwater Benchmarks and Monitoring Results STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT SAMPLES COLLECTED DURING CALENDAR YEAR: 2018 (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.) RECEIVED SEP 11 2018 COUNTY: Hertford PHONE NO. (252) 332-6308 CENTRAL F1LES DWR SECTION PLEASE REMEMBER TO SIGN ON THE NEXT PAGE �l 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 78241 pH, Standard Units Total Suspended 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 (Tiers 2 and 3) 0.03 1.0 001 07/23/2018 1.55 7.0 1.6 <12 0.0065 Exempt 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." L Name (Print name) Er -4-r rc Title (Print title) Signature Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center North Carolina 27699-1617 ,?— 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 penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee or Designee) (Date) Form SWU-251, last revised October 25, 2012 Page 2 of 2 CERTIFICATE OF COVERAGE NO. NCG10013 0 FACILITY NAME Liverman's Automotive, Inc. PERSON COLLECTING SAMPLE(S) Allen Liverman CERTIFIED LABORATORY(S) Lab # 314 Part A: Stormwater Benchmarks and Monitoring Results STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT SAMPLES COLLECTED DURING CALENDAR YEAR: 2018 (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.) EL tV E D COUNTY: Hertford JUL 2 5 2018 PHONE NO. (252) 332-6308 CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE NEXT PAGE �l DWR SECTION 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 78142 pH, Standard Units Total Suspended 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 Organia3, mg/L Benchmark - G c 6.0 — 9.01 100/50Z 1s 8,000 (Tiers 2. and 3) 0.03 1.0 Exempt 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 11 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." q) 1 +r 4- 0- Q► Name (Print name) Title [/(Print �title) 'L S Signature 7- 19=t9- Date Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center 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." (Signature of Permittee or Designee) i-- i 5 -ice (Date) Form SWU-251, lost revised October 25, 2012 Page 2 of 2 STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT CERTIFICATE OF COVERAGE NO. NCG100 130 _ SAMPLES COLLECTED DURING CALENDAR YEAR: _2017 (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.) -GO V ED FACILITY NAME _ Liverman's Automotive, Inc. COUNTY: Hertford PERSON COLLECTING SAMPLE(S) _Allen Liverman 1111 fir, 1U17 PHONE NO. L25ZJ332-6308 CERTIFIED LABORATORY(S) Lab # 314 CENTf� FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4 DWR 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 1 Total Rainfall, inches 00400 00S30 - - - - 77023 01051 78141 pH, Standard Units Total Suspended 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 — 9.0� 100/50z 15 8,000 (Tiers 2 and 3) 0.03 1.0 003 05/23/2017 1.2S 7.3 29 4.6 <12.0 <0.0050 Exempt JI 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 1 of 2 -_-w 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." '�`! ) �L Ca'.-t Name (Print name) Title (Print title) 0 a, 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." (Signature of Permittee or Designee) (Date) Form SW U-251, lost revised October 25, 2012 Page 2 of 2 STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT CERTIFICATE OF COVERAGE NO. NCG100 _130_ _ _ SAMPLES COLLECTED DURING CALENDAR YEAR: _2016 R EC E! VE DThis monitoring report shall be received by the Division no later than 30 days FEB O $ 2917 from the date the facility receives the sampling results from the laboratory.) FACILITY NAME _ Liverman's Automotive, Inc. f ;1=NTRA T,c � PERSON COLLECTING SAMPLE(S) _N/A DWR SECTinm CERTIFIED LABORATORY(S) N/A Lab # Lab # Part A: Stormwater Benchmarks and Monitoring Results COUNTY Hertford PHONE NO. (_252)332 6380 322- r-j,v67 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. 'Outfall P No "Datez�00400" . �Sai 6oi Collected, ,Eno .ddRainfall Toiai : ¢ �;00530 _ 9YF - -- 'Y y77023 01051 78141 _. .. pH, �Standard5o nt _ ..ML _` lot i SuspendeclY ds l? SS}, �Mod C .:... _Y'H-�.GF wit ::r.. Nart-polar O$iG H� I F� i66 SGT HEMj,.mi►1/L .. ..�r.x�a -Qe_. Ethjrlene Glycol, d m L l s w.-. a', Total Srable, mg/ MWOErd Total Toxic °_ 3 _mT 01- ,.:l3en 0 ojes 03c0(Tz :5 Exempt 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. ISee 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 6-4. 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 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." 411 z,,, L,, A►, c n Name (Print name) Title (Print title) Signature Date Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center 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." (Signature of Permittee or Designee) Ir2747 (Date) Form SW U-251, last revised October 25, 2012 Page 2 of 2 STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT CEalFICATE OF COVERAGE NO. NCG100 130 FACILITY NAME _ liverman's Automotive, Inc. PERSON COLLECTING SAMPLE(S) _N/A CERTIFIED LABORATORY(S) N/A Lab # Lab # Part A: Stormwater Benchmarks and Monitoring Results SAMPLES COLLECTED DURING CALENDAR YEAR: _2016 (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 Hertford PHONE NO. L252T)332-6308 R�CENOPSE REMEMBER TO SIGN ON THE REVERSE AUG 1 i 2m CENTRAL F=I.LE For sampling periods with no discharge, you must submit this discharygF;pouir( orm noting "No Flow" or "No Discharge" within 30 days of the end of that period to comply with permit reporting requirements. r�r 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 Non -polar O&G/TPH (Method 1664 SGT-HEM), mg/L Ethylene Glycol, mg/L Lead, Total Recoverable, mg/L Total To Organics3, mg/L Benchmark - - 6.0 — 9.01 100/50, 15 8,000 (Tiers 2 and 3) 0.03 1.0 Exempt Note: If you report a samDled value in excess of the benchmark value. or outside the benchmark ranee for DH. 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 October 25, 2012 Page 1 of 2 STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT ./I FaciAties 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) p, . . Title (Print title) Signature Date Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center 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." (Signature of Permittee or Designee) (Date) Form SWU-251, last revised October25, 2012 Page 2 of 2 STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Cap CERTIFICATE OF COVERAGE NO. NCG100 _1_ _3_ _0_ SAMPLES COLLECTED DURING CALENDAR Z1)15 (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 Liverman's Automotive, Inc. COUNTY Hertford PERSON COLLECTING SAMPLE(S) Allen Liverman PHONE NO. 252 332-6308 CERTIFIED LABORATORY(S) Test America Lab # 314 RECEIVED Lab # FEB 2��PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Part A: Stormwater Benchmarks and Monitoring Results CENTRAL FILES DUVR SECTION 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 — 9.01 100/502 15 8,000 (Tiers 2 and 3) 0.03 1.0 001 12/18/2015 0.9 100 <1.6 <20 0.017 Exempt 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. ;See 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 October 25, 2012 Page 1 of 2 's 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." 1 1 2 n L i, L rA r- r -. CL Name (Print name) ' Title (Print title) ^ --i� Signature Date Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center 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." (Signature of Permittee or Designee) (Date) Form SWU-251, lost revised October25, 2012 Page 2 of 2 CERTIFICATE OF COVERAGE NO. NCG100 STORMWATER DISCHARGE OUTFALL ($DO) MONITORING REPORT SAMPLES COLLECTED DURING CALENDAR YEAR: _2014_ (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 Liverman's Automotive, Inc. COUNTY Hertford 60" PERSON COLLECTING SAMPLE(S) Allen Liverman RECENEDPHONE NO. L252_) 332-6308 CERTIFIED LABORATORY(S) Test America Lab #_314` r Lab # JqN 15 2015 PLEASE REMEMBER TO SIGN ON THE REVERSE 4 ^, CENTRAL FILES C3 Part A: Stormwater Benchmarks and Monitoring Results DWR SECTION v . 0 For sampling periods with no discharge, you must submit this discharge monitoring form noting "No Flow" or "No Discharge" within W.W10 30 days of the end of that period to comply with permit reporting requirements. Outfall _ M Dated �0040040530 ` - '- 77023 —�.- 01051. 78141 Na R x Sample Collected, mo/dd%year�RainfaEl,5tandard'� Tota pH :Total Suspended Non -polar O&G%TPH Ethyle a Glycol; _ rrig/i Lead,, -Total -Recoverable, %tal Toxic - z Or nit53 � } inch ^ Units Fmg/L {Method 1664' mg/L .:$GT-HEMJ, _ -- mg/L mg/L 2 8encchma k� Y_ 100/50 15_ �_ (Tiers%2 nd,3) 0:03 1.0 003 12/16/2014 0.06 140 3.8 23 0.03 Exempt 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, lost 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." Name (Print name) 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." (Signature of Permittee or Designee) (Date) Form SWU-251, last revised October25, 2012 Page 2 of 2