NCG060352_MONITORING INFO_20191230

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
qC G D (.,o L),3
DOC TYPE
❑ HISTORICAL FILE
QXMONITORING REPORTS
DOC DATE
❑ �� % 3 0
YYYYMMDD

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000 I `t i {
Date submitted 2 ��r��{ V
CERTIFICATE OF COVERAGE NO. NCG06 0 3 S
FACILITY NAME 5+0 C {� c 3Q7 Co�/CJr l rk Llo. Su+�►�
COUNTY l^a Innr 4 C
PERSON COLLECTING SAMPLES
Lab Cert. #
SAMPLE COLLECTION YEAR Z Ot DEC 3 0 "1
FACILITY ACTIVITIES INCLUDE (check all that apply): CAcN „t}L v iLF_:
❑ use/process meats ® use animal fats/byproduct
sgECl ION!
DISCHARGING TO SALTWATERS? DYES ®NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Tnfnl a„nnr rninfnu' A or n No discharqe this period'
Part A: Stormwater
Outfall No.
Benchmark
5 0
BenchmarKs ano
Sample Collected,
mo/dd/yr
-
0
iwonnonng
TSS,
mg/L
100or504
rcewn5
pH,
Standard units
Within 6.0 - 9.0
,6
COD,
mg/L
120
D
I •-,•-• - •-.
Oil and Grease,
mg/L
30
N
- —
Fecal Coliform',
Colonies per 100 ml
1000
Enterococci',
Colonies per 100 ml
Soo
' 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 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 (if yes, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
i
' 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 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Last Revised: October 18, 201
SWU-249 Page I of

*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:
Mail an original and one copy of this DMR including all "No Discharge" reports within 30 days of receipt of the lab results (or 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 27699-1617
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."
[-A/ z 19 19
(Signature of Permittee) (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
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