NCG060280_MONITORING INFO_20200121

Vv l i`l , b
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
njC G 0
DOC TYPE
❑ HISTORICAL FILE
[ MONITORING REPORTS
DOC DATE
❑ OOaD 0 I a r
YYYYMMDD

CERTIFICATE OF
FACILITY NAME
COUNTY
PERSON COLLEC
LABORATORY
STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000
Date submitted
w o
Lab Cert. #
JAN I12020
TV�Al­ FILES
DWR SECTION
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR QO 19
SAMPLE PERIOD ❑ Jan -June klmy-Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow []Water SuppIV ❑SA
[=}Ocher L(4SS Ci J(,
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats �animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
I
Total event rainfall a s or No discharge this period3
'
Outfell;No.,
.,./,
-Collectedsmo dd r
y�,,
1 '>m5/L
�,i ,.,'r
Standard units :.
. _.,.
, mODL z
011 anrd G� ase,
',,; /
,Fecal Collform
Colonies er-100 ml
f Enterococd,
„-Colonies er 300 ml
Benchmark
' r �
",100or,504.;
,Wlthln6.0:';B.O
a= as120,+ °
°y,,, . 30 t.rr�.r ,,
1000'r+;-
.,'Soo,
Parameter Code
": --'i'-
,;-00530. "�'rf
00400*.'t;P,`.>.,'100340
-.,s,F:,a00556':-( r
'31616""
61211
L
AI
' Only applies to facilities that use/process meats.
'The total precipitation must be recorded using data from an on -site rain gauge.
' For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
'See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
sMonthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Did this facility perform Vehicle Maintenance Activities using more than'55 gallons of new oil per month?❑ yes no (ifyes• complete Part B)
Permit Date: 11/1/2018-05/31/2021
SWU-249, Last Revised 11/5/2018
Page 1 of 2

Part B: Vehicle Maintenance Area Monitorin¢ Results: oniv for facilities averaging > Sr, gal of npw mnrnr nu/month
OuNell No ,
iDate1arnPle;Collected
Imo/dd/yr)2 �,
;24ahour ralntall'amaunt;,
a 7tY „Inchasa 1,) a
/rt NewlMotor,DIN, it
Cr O11 UYageE �
U Non Polnr 0&0/Total
�Patro*m H droca bone
Y f
y Total,SuspandedSolids
n "'q
ti r t
eanchina'rkst , ..,,r`
+4 I r t 6 2 )
Par . r,
u u� i
,tr4 C,. �r
. ,.: ....
' n s s' T`
�E ,., i„
18 m L „'
f`.�° 8/ .w�'. r ._.-.
300'mg/C,or,90img/L';r'.
PgrameterCode
, ,46829t ,'�{,i,,
��!;NCOIL„
x i00932,
hootnotes from Part A also apply to Part B
'FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART II SECTION B.
2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION l
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES [I NO
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES Q NO
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR including all "No Discharge" reports within 30 days of receipt of the lab results for at end of monitoring period in the case
of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
161kMail Service Center
Raleigh, NC 27699-161Z,
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 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 vlolatiytns." _
Signature of
Permit Date: 11/1/2018-05/31/2021
1-lo--ao
Date
SWU-249, Last Revised 11/5/2018
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