NCG140135_MONITORING INFO_20190224

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STORMWATER DIVISION CODING SHEEP
NCG PERMITS
PERMIT NO.
IV Cc
DOC TYPE
El HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ )o' j � D ) y
YYYYMMDD

9 0 9
STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF CO ERAGE NO. NCG14Q I _a f
FACILITY NAME: b " e
PERSON COLLECTING AMPLES
CERTIFIED LABORATORY g!5C&4 MAje. 1J 1 Lab # Zje
Lab #
OPTIONAL INFO:
Part A. Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR:0��
SAMPLING PERIOD: July -December January -June
COUNTY A091W3fo
PHONE N0. (�j
ADD TO LISTSERVE? ❑YES NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
PH
(Standard
Units}
TSS
(mg/L)
Event
Duration
(minutes]
Total d
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
It of Months in Tier
2 Samplingx
-
-
5-92
100 '3
-
!
tip . •J
2.
-7.
ZgQ
z.a
ri
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfaI] here. Please make sure to mark the sample period above-
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range,
3 TSS benchmark values are 100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I.
` For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
:CFI T 0
FHB 2
:N, RAt
iVlp,
Permit Date: 7/1/2011-60/30/2015 Date of last pH meter calibration: 1 Last Revised 7/13/11
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Part R: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month —averaged over a calendar year.
Outfall
No.
Date Sample
p
Collected
(mo/dd/yr)'
pH
{Standard
Units}
TPH using method
1664ASGT-HEM
(mg/L)
Total Suspended
Solids
(mg/Lj
Event
Duration
(minutes)
Total
Rainfall'
(in)
New Motor oil
Usage
(gal/month)
In Tier 2
Monthly
Monitoring?
Wn)
i
# of Months
in Tier 2
Samplingz
6-9
is
100 2,1
I
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEE CES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO�
HAVE YOU CONTACTED THE REGION? YES ❑ NO� Q
REGIONAL OFFICE CONTACT NAME: TTTTTri�����
Mail Original and one copy of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample for at end of monitoring oeriod
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that a]Ified per a properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those pe o di ctly o ible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aw a at r e i ificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Ct
(Sign ture of Per ittee) ' (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
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