HomeMy WebLinkAboutNCG100163_MONITORING INFO_20151230STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v C� �00J �D
DOC TYPE
❑HISTORICAL FILE
BWONITORING REPORTS
DOC DATE
❑ a'CJJ 5 1a '3
YYYYMMDD
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
CERTIFICATE OF COVERAGE NO. NCG100 0 0 0
lv C cflobl6.3
FACILITY NAME Worthington Ag Paris
PERSON COLLECTING SAMPLE(S) Skip Leigh
CERTIFIED LABORATORY(S) Pace Analylical Lab # 5342
Lab #
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLES COLLECTED DURING CALENDAR YEAR: 2015
(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.)
RECEN'=Dy Wayne
(jEL 3 PZ.HONE NO. ( 419 ) 735-0987
CENTRAL FPLE*E REMEMBER TO SIGN ON THE REVERSE 4
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
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
-
-
1
6.0 — 9.0
2
100/50
15
8,000
(Tiers 2 and 3)
0.03
1.0
001
11/21/2015
0.9
5.0
8.0
ND
--
ND
ND
001
12/15/2015
0.5
--
--
ND
--
--
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 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."
Skip Leigh
Name (Print name)
Manager
Title (Pri it _
Si ature 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 t[Vere are signif!pant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
/1-1 -19-/s
(Signatd of Permittee or DelWnee) (Date)
Form SWU-251, last revised October 25, 2012
Page 2 of 2
(7'
RECEIVED
JAN 21 Z015
I
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
CERTIFICATE OF COVERAGE NO. NCG100 6 V 0
1�'C 6- i 0 0 / k3
FACILITY NAME W n 241- -/ 1,4 on/ �y P�� k5 -
PERSON COLLECTING SAMPLES} SK; a L e +9 4
CERTIFIED LABORATORY(S) /4 CE
Lab #
Part A. 5to rmwater Benchmarks and Monitoring Results
CENTRAL FILES
DWRS�ECTION
SAMPLES COLLECTED DURING CALENDAR YEAR: oC (D / V
(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.)
At C
COUNTY
PHONE NO.{_) O q 2 -I
rn
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
For sampling periods with no discharge, you mast submit this discharge monitoring form rioting "No Flow" or "No Discharge" within
30 days of the End of that period to comply with permit reporting requirements.
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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 *e 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.
z
See General Permit text to identify whether the moreprotective 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 40Code of Federal Regulations (CFR) Part 122.
Form SWU-251, lost revised October25, 2012
Page Iof2
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 Certificotioo Stotement
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TToj, 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 storrnwater
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 Nan."
:5K,f /-e;9 i-�
Name (Print name)
Title (Print tile)
Signature
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
161T Mail Service Center
Raleigh, 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 evaluatethe information submitted. eased on myinquiry 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-9 Permitteeor Designee)
/// q//_s-
{Date}
Form SW U-251, lost revised October 25, 2012
Page 2 of 2
RE E 1! n
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C-
,--I�b I �3
CERTIFICATE OF COVERAGE NO. NCG100 0 4 0
STORMWATER DISCHARGE OUTFALL (SOO)
MONITORING REPORT
FACILITY NAME Worthington Ag Parts
PERSON COLLECTING SAMPLE(S) Skip Leigh
CERTIFIED LABORATORY(S) Pace Analytical Lab #_ 53�
Lab #
Part A: Stormwater Benchmarks and Monitoring liesults
CENTRAL. FILE`
DWQ/80G
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.)
COUNTY Wayne - -
PHONE NO. 9( -19 -j 735-0997
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
For sampling periods with no dischorge; 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.
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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 Ti ~jti ftGeneral
Permit. QJ$OG
ISee If pH values outside this range are recorded in sampled stormwater discharges, but ambient precipitation pH Jeveis 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 Total precipitation data) must be
documented to demonstrate background concentrations were below the benchmark pH range of 6-9,
ISee 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, 1012
Page Iof2
5TORMWA7ER DISCHARGE OUTFAILL (SDO)
MONITORING REPORT
Facilities that #ncorporate a solvent management plan into the 5tormwater 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 tht, last discharge monitoring report. I further certify that this facility is implementing all the provisions of the solvent
management plan included in the 5tormwater Pollution Prevention Plan."
Skip Leigh
Name (Print name)
Manager
Title {Print titl
Sig na re Date
Mall Original and one copy to:
Division of Water Qua Ilty
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 an 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 aMslgnificant penaltiesfor submitting false information, including the possibility of fines and imprisonment for knowing violations."
N-
or
(Date}
Form SWU-251, lost revised October25, 2012
Page 2 of 2