HomeMy WebLinkAboutNCG060385_MONITORING INFO_20190122STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V uc Q (p (58
DOC TYPE
❑ HISTORICAL FILE
Pq MONITORING REPORTS
DOC DATE
❑ a'U� �f a'�
YYYYM M D D
SEMI-ANNUAL. STORMWATER DISCHARGE MONITORING REPORT RECEIVED
for North Carolina Division of Water u lity-General Permit No. NCG060000 JAN 2 2 201.
Date submitted S CENTRAL FILES
CERTIFICATE OF COVERAGE NO. G06Q a ly 5 (J SAMPLE COLLECTION YEAR U 4 DWR SECT10i i
FACILITY NAME GPy h FACILITY ACTIVITIES INCLUDE (check all that apply):
-COUNTY use/process meats ❑ use animal fats/byproducts
PERSON COLLERING�SAMPL S 1Nv�S DISCHARGING TO SALTWATERS? []YES NNO
LABORATORY 1'1� ab Cert. # L40
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall 2111 j _�^ or ❑ No discharge this period3
Outfall No.
Sample Collected,
mo/dd/yr
T55,3� . ,'
mg/L*=
pkl,
Standard units
COD,
mg/L ` '
OiI and Grease,
1, mg/L•
.'Fecal Collform , '• `
Colonies per l00 ml
Enterococcl.,�
Coionies'per 100 i
Ben m rk
-
100ar,�0
Within6.D-9.D•
120w
.30`k
ii lODO' s
500
1,3O 1y
N +
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 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 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ®no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
0utfall No A
Sample Collected,'- •
mo/dd/yr
Oil and Grease, '. '
i�'' mg%L,
Tss,
mg/L _
: ' -PH _.�
^Standard units,
New Motor Oil Usage,
Atl6wl�averagegal/ma.-
Benchmark
f
30
100 or 50
# .6.6" 9.0 •
' �� �-. 5"''>
1 Only applies to facilities that use/process meats.-
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 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 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if }Les complete Part B)
5WU-249 Last Revised: October 18, 2012
Page I of 2
*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDA INCE 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 It SECTION B.
a TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
.Q
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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 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."
(Signature of
Additional copies of this form
i S'
(Date)
be downloaded at: http://portal,ncdenr.orp/web/wq/ws/su/npdessw#tab-4
S W U-249
Last Revised: October 18, 2012
Page 2 of 2
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Qu l!!i �General Permit No. NCG060000
Date submitted t l b
CERTIFICATE OF COVERAGE NO. G06O.3 g S F I!C-*MI 'SAMPLE COLLECTION YEAR M U"6
FACILITY NAME ACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY lrraw 4 '� `� t 2��8 ❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLE.CTING SAMP ES l CFNTI.7L� I FILI ISCHARGING TO SALTWATERS? []YES ®NO
LABORATORYFAC,� %. ,AAA NAcUab Cert. # DWR SECTIOW
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall 2 I'l% or ❑ No discharge this period'
Outfall No.
Sample Collected,
mo/dd/yr
T.SS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
100 br 50
Within 6.0-9.0
120
30
1000
S00
1
+S
"
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 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 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ® no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0 — 9.0
-
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at a y outfalls, you must still submit this discharge monitoring report with a checkmark here.
45ee General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies
(ifyes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2
*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 B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES [] NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
this DMR."includina all "No Discharae" reports, within 30 days of receipt of the lab results for at end
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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 there are significant penalties for submitting false
information includpossibility of fines and imprisonment for knowing violations."
rmittee)
Additional copies of this form
(Date) A
iy be downldaded'at: http://portal.ncdenr.orgJweb/wa/ws/su/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2