NCG060026_MONITORING INFO_20190904

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑ HISTORICAL FILE
I' MONITORING REPORTS
DOC DATE
❑ Q o A D� 0
YYYYM M D D

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG0600d0`ECE!\f
Date submitted O `U 0 '( /
CERTIFICATE OF C VERAGE^f O NCG06O z, 1
FACILITY NA 2LA.) �p OR ��, l,0- lQi
COUNTY Q's II
PERSON COLLECTING SA ES JET
LABORATORY �i\Ll�foe_ Lab Cert. # _
Part A: Stormwater Benchmarks and Monitoring Results
SEP 0 4 2019
n O I n DENR-LAND QUALITY
SAMPLE COLLECTION YEAR o� l `� STORMWATER PERMITTING
SAMPLE PERIOD ❑ Jan -June ❑ J y-Dec
or [g-�nthlys month
Ili
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero-flo�L❑Water Supply ❑SA
EL ntTeer GS s11J
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats use animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
II
Total event rainfall z . 5 or ❑ No discharge this period'
Outfall=No.'
-
Date Semple
' Collected,.mo/dd/ r
TSS,
mg/L;..,
pH,.
Sfandard.units
COD,
" mg/L . ..
Oil and.Grease, .
mg/L.
Fecaltoliform,
Colonles p ei 30o ml :
Enterococcl,
-Colonles er SOO ml
Benchmark .
100 or, 504 `
Within 'CO"9.0'
" ..120
30 '
10001
500,
Parameter Code
--. -
'C0530
-r - 00400'". `
7.'00340
+' 00556 '
- ,' 31616
61211
1 Only applies to facilities that use/process meats.
'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.
4See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
'Monthly 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 (if yes, 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 Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month
Outtall No.
Date SampleXollecteid.,-24
(ma/dd/yr)
hour rainfall amount;
Inches'
'New Mbtor 011 or;
Hydraullc Oil Usage
Non' -Polar O&G/Total
Petroleum,Hydrbcarbons
Total Suspended Solids
Benchmarks,
iS nig/L
SOO mg/Lor 50 mg/L"
Parameter Code,'
- j.46529 , ;� ,, .
°' " ': NCOIL00552
-CO530
Footnotes 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 B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES OR THE SAME PARAMETER AT ANYONE OUTFALL? YES E 0 ❑
IF YES, HAVE YOU CONTACTED THE DE L REGION_A1L OFFICE? YES \� NO ❑
REGIONAL OFFICE CONTACT NAME:\� i��r t�RS �heec� s�.�{o N C� EJv�L(Z G�l n-eccr
U ,
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
1617,,Mail Service Center
Raleigh, NC 27699-161T—
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 violatians.; _
Signature of
Permit Date: 11/1/2018-05/31/2021
B- 30-1
Date
SWU-249, Last Revised 11/5/2018
Page 2 of 2

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000 r� r—^ ( /C�y
Rt'CFI ED
Date submitted 8 `3 b _0 SEP 0 4 2019
DENR-LAND QUALITY
CERTIFICATE OF C VERAGE/J�O NNC\G06� Q� � SAMPLE COLLECTION YEAR �V � 1 STORMWATER PERMITTING
FACILITY NA 2t� l�0 y` SAMPLE PERIOD ❑ Jan -June ❑ J y-Dec
COUNTY CtS �^ 1 or EP-Moonthlys month
PERSON COLLECTING SA ES J V `{`
LABORATORYLab Cert. # DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
[]zero-flo ❑Water Supply ❑SA
eOii er ASS
Part A: Stormwater Benchmarks and Monitoring Results
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats use animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE
IJ
Total event rainfall' o or ❑ No discharge this period'
Outiall No
'
Date Semple
Collected .mo/dd/ r
TSS
'm /L
pH ,, y ,
� Standardiiinits
COD
'Ong/L...m
OII and,Grease
/C: ^
Fecal Collform,
J'Colonles ei:100 m1
Enterococci,
.. Colonles per 100'ml
Benchmark f
" :100 or 50" •
'iWlthln &O.: 9 0
1I0..'„a
30 :' ��
�=10oo'i
->-Soo,
Parameter Code,
C0530, '
- 00400'
;'*u00340
r' ,'OOSS6.-
^>" 31616'^
61211
' 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.
'Monthly 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 Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month
Outfall Na '
.<.
fDa�a Sample Collected
mo/dd °r
/Y�1 ,.,
�2A hour iainfahaniount,_a
. Ihches
t,� w
NawiMptori011 or .� a
. �Hydrayllc OII Usages,
, Nori Polar O&(%,Total
Petroleum Hydrocarbons
Total Swpended Solids:
'Bench ma'rks
..",.100mg/c6is0mg/Le
PgrnmeferCode ,.:c
_,;
�; . ;A652J,.'f='
00552" �
;r, `,; CO530
Footnotes 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 B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES OR THE SAME PARAMETER AT ANY ONE OUTFALL? YES 2<0
El
IF YES, HAVE YOU CONTACTED THE DE L REGION_pr L�O"�FFIC�E�? �YES \�] NO r� rnrn
REGIONAL OFFICE CONTACT NAME: Cq�, ny \L�rs— tY�< ���� N Qj) eA
Mail an original copy of this OMR 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" reportsl to:
Division of Water Quality
Attn: DWQ Central Files
1612\Mail Service Center
Raleigh, NC 27699-161T,
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 violatlans. � _
Signature of
Permit Date: 11/1/2018-05/31/2021
9- 30-1
Date
SWU-249, Last Revised 11/5/2018
Page 2 of 2