"Industrial Stormwater Discharge Monitoring Report - 1200-a Permit" - Oregon

Industrial Stormwater Discharge Monitoring Report - 1200-a Permit is a legal document that was released by the Oregon Department of Environmental Quality - a government authority operating within Oregon.

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  • Released on June 8, 2015;
  • The latest edition currently provided by the Oregon Department of Environmental Quality;
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Download "Industrial Stormwater Discharge Monitoring Report - 1200-a Permit" - Oregon

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Industrial Stormwater Discharge Monitoring Report - 1200-A Permit
Permittee Legal Name:
ODEQ File No./Facility ID:
Facility Common Name:
Reporting Period:
July 1,
to
June 30,
Facility Location:
Laboratory Name:
County:
Laboratory ORELAP #:
Monitor for the following pollutants at sampling point(s) specified in your SWPCP and use the sampling point name or number from your SWPCP. Add more sheets if necessary (e.g., if more than 4
samples are collected per pollutant or facility has more than 4 sampling points). You MUST also attach a copy of laboratory results sheet(s).
Benchmark/Limit Sampling: 4 times per year, every year
Name or Number of
Suspended
Oil and
Settleable
Fill out only those rows and columns that apply to your specific site.
pH
Sampling Point(s)
Solids, Total
Grease, Total
Solids
Sample Date
(group data per
Note 1: Submit this report to the appropriate DEQ regional office or agent (see below) annually by July 31st. The
s.u.
mg/L
mg/L
ml/L
sampling point)
report must contain the results of all stormwater monitoring conducted during the year. If you have a monitoring
waiver for one or more of the pollutant(s), please report “W” in the column(s)-see permit-Schedule B.3.
Note 2: Non-detects must be reported as "ND" along with the applicable method detection limit or minimum
quantification limit in parentheses - e.g. ND (0.001).
Note 3: If a stormwater sampling result exceeds any of the benchmark values, the permit registrant must, within 30
calendar days of receiving the sampling results, investigate the cause of the benchmark exceedance(s), review the
Geometric Mean (Note 4)
SWPCP and sumarize the results and corrective actions. and revise the SWPCP as necessary.
Note 4: For non-detect sampling results, use 1/2 the detection limit to calculate the geometric mean. You are not
required to report the geometric mean for pollutant(s) that have a monitoring waiver. The geometric mean value is
automatically calculated if using the Excel version of the DMR form. Tier II Corrective Action requirements (permit
section A.13) are based on results of geometric mean evaluation during the second year of permit coverage.
Geometric Mean (Note 4)
Note 5: If a sampling event is missed or a sampling parameter is not analyzed or sampled, enter "NS" in each
applicable column for that row.
Note 6: If there was no discharge then state "No Discharge" in the row after the sampling date for any applicable
sampling point.
Note 7: If you are required to conduct effluent limit sampling for pH or total suspended solids, you do not need to
conduct benchmark sampling for those parameters.
Geometric Mean (Note 4)
Note 8: The permit registrant is not required to conduct monitoring for the remainder of the permit term if a site is
inactive and has effective erosion and sediment control measures in exposed areas. Please provide documentation with
the DMR form indicating that the site is temporarily inactive.
Geometric Mean (Note 4)
Permit Benchmark
5.5 - 9.0
100
10
0.20
Name/Title Principal Executive Officer or Authorized Delegate
(Please Print)
Telephone:
Email:
I certify, under penalty of law, that this document and all attachments were prepared under my direct 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.
Sign here:
Date
Last updated by Mark Riedel-Bash
06/08/2015 -- 08-WQ-033
Industrial Stormwater Discharge Monitoring Report - 1200-A Permit
Permittee Legal Name:
ODEQ File No./Facility ID:
Facility Common Name:
Reporting Period:
July 1,
to
June 30,
Facility Location:
Laboratory Name:
County:
Laboratory ORELAP #:
Monitor for the following pollutants at sampling point(s) specified in your SWPCP and use the sampling point name or number from your SWPCP. Add more sheets if necessary (e.g., if more than 4
samples are collected per pollutant or facility has more than 4 sampling points). You MUST also attach a copy of laboratory results sheet(s).
Benchmark/Limit Sampling: 4 times per year, every year
Name or Number of
Suspended
Oil and
Settleable
Fill out only those rows and columns that apply to your specific site.
pH
Sampling Point(s)
Solids, Total
Grease, Total
Solids
Sample Date
(group data per
Note 1: Submit this report to the appropriate DEQ regional office or agent (see below) annually by July 31st. The
s.u.
mg/L
mg/L
ml/L
sampling point)
report must contain the results of all stormwater monitoring conducted during the year. If you have a monitoring
waiver for one or more of the pollutant(s), please report “W” in the column(s)-see permit-Schedule B.3.
Note 2: Non-detects must be reported as "ND" along with the applicable method detection limit or minimum
quantification limit in parentheses - e.g. ND (0.001).
Note 3: If a stormwater sampling result exceeds any of the benchmark values, the permit registrant must, within 30
calendar days of receiving the sampling results, investigate the cause of the benchmark exceedance(s), review the
Geometric Mean (Note 4)
SWPCP and sumarize the results and corrective actions. and revise the SWPCP as necessary.
Note 4: For non-detect sampling results, use 1/2 the detection limit to calculate the geometric mean. You are not
required to report the geometric mean for pollutant(s) that have a monitoring waiver. The geometric mean value is
automatically calculated if using the Excel version of the DMR form. Tier II Corrective Action requirements (permit
section A.13) are based on results of geometric mean evaluation during the second year of permit coverage.
Geometric Mean (Note 4)
Note 5: If a sampling event is missed or a sampling parameter is not analyzed or sampled, enter "NS" in each
applicable column for that row.
Note 6: If there was no discharge then state "No Discharge" in the row after the sampling date for any applicable
sampling point.
Note 7: If you are required to conduct effluent limit sampling for pH or total suspended solids, you do not need to
conduct benchmark sampling for those parameters.
Geometric Mean (Note 4)
Note 8: The permit registrant is not required to conduct monitoring for the remainder of the permit term if a site is
inactive and has effective erosion and sediment control measures in exposed areas. Please provide documentation with
the DMR form indicating that the site is temporarily inactive.
Geometric Mean (Note 4)
Permit Benchmark
5.5 - 9.0
100
10
0.20
Name/Title Principal Executive Officer or Authorized Delegate
(Please Print)
Telephone:
Email:
I certify, under penalty of law, that this document and all attachments were prepared under my direct 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.
Sign here:
Date
Last updated by Mark Riedel-Bash
06/08/2015 -- 08-WQ-033
Effluent Limit Sampling (Discharges of mine dewatering water only)
4 Samples Per Year
4 Samples per Year
Fill out only those rows and columns that apply to your
Crushed Rock; Construction Sand and Gravel
specific site.
Industrial Sand (SIC 1446)
(SIC 1422, 1423, 1429, 1442)
Note 1: Operators do not have to conduct benchmark monitoring for any
Suspended
Name or Number of
pH
pH
pollutants for which effluent limit sampling is required.
Solids, Total
Sampling Point(s) (group
Sample Date
mg/L
s.u.
s.u.
data per sampling point)
Note 2: If a stormwater sampling result exceeds any effluent limit value(s), the
permit registrant must, within 30 calendar days of receiving the sampling results,
investigate the cause of the benchmark exceedance(s), review the SWPCP and
sumarize the results and corrective actions. and revise the SWPCP as necessary.
Note 3: For non-detect sampling results, use 1/2 the detection limit to calculate
the geometric mean. You are not required to report the geometric mean for
pollutant(s) that have a monitoring waiver. The geometric mean value is
Geometric Mean (Note 3)
automatically calculated if using the Excel version of the DMR form. Tier II
Corrective Action requirements (permit section A.13) are based on results of
geometric mean evaluation during the second year of permit coverage.
Note 4: If a sampling event is missed or a sampling parameter is not analyzed or
sampled, enter "NS" in each applicable column for that row.
Note 5: If there was no discharge then state "No Discharge" in the row after the
Geometric Mean (Note 3)
sampling date for any applicable sampling point.
Geometric Mean (Note 3)
Geometric Mean (Note 3)
45 (daily max)
Effluent Limit
6.0 - 9.0
6.0 - 9.0
25 (monthly avg.)
For facilities whose permits are administered by the following
For all other locations, please submit one (1) copy of this report and laboratory results sheet(s) and the QA/QC documentation to
entities, please submit one (1) copy of this report and laboratory
the appropriate DEQ regional office annually by July 31st:
results sheet(s) and QA/QC documentation to the local jurisdiction
DEQ Eastern Region Office
DEQ Northwest Region Office
annually by July 31st:
475 NE Bellevue Dr., Suite #110
700 Lloyd Building at 700 NE Multnomah
Bend, OR 97701
St., Suite #600
Portland, OR 97232
Phone: (541) 388-6146
Phone: (503) 229-5263
City of Portland
Department of Geology and
Hours: 8 am - 5 pm
Industrial Stormwater Section
Mineral Industries
Water Pollution Control Lab
229 Broadalbin St SW Albany,
DEQ Western Region Office
6543 N Burlington Ave.
OR 97321
165 East 7th Ave., Suite 100
Portland, OR 97203-5452
(541) 967-2082
Eugene, OR 97401
(503) 823-5320
Phone: (541) 687-7326
Hours: 8 am - 5 pm
Last updated by Mark Riedel-Bash
06/08/2015 -- 08-WQ-033
Additional Sampling: 2 times per year, every year
Impairment Sampling
Fill in only those pollutants for which impairment monitoring is required in your permit assignment letter.
Name or Number of
DDT Metabolite
Sampling Point(s)
Aldrin
Arsenic, Total
Chlordane
Copper
DDT
(DDE)
Dieldrin
Heptachlor
Iron, Total
Lead, Total Mercury, Total
Sample Date
(group data per
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
sampling point)
Last Year's Results*
Current Year Results
Geometric Mean
Reference Concentration
0.003
0.0021
0.0024
0.010
0.0011
0.00001
0.0025
0.00052
1.0
0.017
0.0024
Benzo(b)
Name or Number of
Benz(a)anthra
fluoranthene
Benzo(k)
Dibenz(a,h)
Sampling Point(s)
Sample Date
PCB **
Zinc
cene
Benzo(a)pyrene
3,4
fluoranthene
Chrysene
anthracene
Fluoranthene
Acenaphthene
Anthracene
(group data per
sampling point)
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
Last Year's Results*
Current Year Results
Geometric Mean
0.001
Reference Concentration
0.002
0.041
0.095
2.9
0.001
0.001
0.001
0.001
0.001
0.014
Indeno(1,2,3-
Name or Number of
Fluorene
cd) pyrene
Pyrene
Temperature
Sampling Point(s)
Sample Date
(group data per
mg/L
mg/L
mg/L
°C
sampling point)
Last Year's Results*
Current Year Results
Geometric Mean
Reference Concentration
0.39
0.001
0.29
*
Previous year's results are included in order to calculate geometric mean. Leave blank if in the first year of permit coverage.
**
0.002 mg/L (based on the sum of the following aroclors 1016, 1221, 1232, 1242, 1248, 1254, 1260)
Last updated by Mark Riedel-Bash
06/08/2015 -- 08-WQ-033
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