NCG020106 DMR SW (2)

II ANNUAL ,SUMMA' DMR - STORMWATER II
SEND TO CENTRAL OFFICE*
STORMWA TER DISCHARGE OUTFALLS (SDO)
GENERAL PERMIT NO. NCG020000
-Report .4LL S70RA1111A 76R Monitoring Data on this form (including No Floiy and No Discharge and Per»ut Lieut Violations) by MARCH 1 of each year
CERTIFICATE OF COVERAGE NO. NCG020106 SAMPLE COLLECTION YEAR: 2015
FACILITY NAME: Pee Dee Quarry COUNTY: Anson
PERSON COLLECTING SAMPLES: N/A PRONE NO. [phone]
CERTIFIED LABORATORY: PACE ANALYTICAL Lab #12 ADD TO LISTERVE? YES ❑ NO ❑ EMAIL:
Part A Stonnwater Monitoring Requirements
Date Sample
Outfall Collected
No. (mo/dd/yr OR
NO FLOW)'
Li Tier 2
Monthly
Monitoring?
(/n)
# of Months in Total Flow
Tier 2 (MG)
Sampling
Total Suspended Total Event
Solids Turbidity° Settleable Rainfall Duration
(mg/1) (NTU) Solids (ml/1) (tri)
- -
-
- -
1003'4 See Footnote 3,40.1 3
No SW Outfalls Exist on Site
Pee Dee Quarry is an undeveloped green site
IIf "NO FLOW" of "NO DISCHARGE," enter "NO FLOW" of "NO DISCHARGE" for each outfall here and the Date Range
'`Pei NCG02 Tiei 2 Monthly Sampling shall be done until 3 consecutive samples aie below the benchmaik or within the benchmaik range
IIf a value is in excess of the benchmaik, or outside the benclimaik iunge (foi pH), you must implement the Teir I or Tiei 2 responses in the General Permit
4TSS benclimaik values are 100 mg/1 except in ORW, HWQ, tiout, and PNA waters where they aie 50 mg/l
5The dischaige shall not cause an instantaneous measurement of the tuibidity of the receiving water to exceed 10 NTU for freshwater streams, lakes, and reservois designated
as trout wateis, 25 NTU for all lakes and reseivois, and all salt watei, 50 NTU for all other streams and surface waters Tuibidity may be monitored at the SDO
Alternatively, the peniuttee may choose to monitoi tiubidity in the receiving water, duectly upstream and downstream of the SDO
Permit Date 1/1/2010-12/31/2014 Last Revised 01-21-11
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Part A• Vehicle Maintenance Activity Monitoring Requirements for facilities using> 55 gal of new motor oil/month on average
Date Sample
Outfall Collected
No. (mo/dd/yr OR
NO FLOW)'
In Tier 2
Monthly # of Months in New Motor
Monitoring? Tier 2 Oil Usage
(y/n) Sampling (gal/month)
-
Total Flow TPH rising method
(MG) 1664A SCT -HEM
(mg/1)
- 15 3
Total Suspended
Solids
(mg/1)
100 3
pH Total Event
(Standard Rainfall Duration
Units) (in)
6-9 3
N/A
0
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EKCEEDENCES
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
WHO AT THE REGION HAVE YOU SPOKEN WITH?
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE" & LIMIT
VIOLATIONS) BY MARCH 1 OF EACH YEAR TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOUMUST SIGN THIS CERTIFICATION FOR ANY INFORMA TION REPOR TED:
"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 sumbitted. 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 imprisionment for knowing
violations."
' AZ
(Signature of Permittee
Permit Date l/1/2010-12/31/2014
(Date)
2/15/16
Last Revised 01-21-11
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