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Home My WebLink AboutNCG060241_MONITORING INFO_20170131W 5 I C. b STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. /V DOC TYPE Cl HISTORICAL FILE MONITORING REPORTS DOC DATE ❑ �'F' I O � 3 YYYYMMDD SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted 1[5/2017 CERTIFICATE OF COVERAGE NO. NCG 06 02 41 FACILITY NAME Liggett Group LLC COUNTY Alamance PERSON COLLECTING SAMPLES Vince Fallon LABORATORY ENCO Lab-Cert. # 591 & 442 Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2016 FACILITY ACTIVITIES INCLUDE (check all that apply): ❑ use/process meats ❑ use animal fats/byproducts DISCHARGING TO SALTWATERS? ❑YES X NO PLEASE REMEMBER TO SIGN ON THE REVERSE -> Total event rainfall z or ® No discharge this period' RECEIVE JAIL 31 2017 CENTRAL FILE; DWiR SECTION Outfall'•No ;Sample Collected mo/dd/yr •_ ?-:•T55; mg%L., 'phi;; ;_,StandardFunits.., COD, mg/L -Oil'and4rease, ,mg/L FecahColiforml„ Col6nies.per.100=mlr Enterococcil, Colonies per:100 mi. Benchmark- - y"•100"or"50- :'.-Wi6im6%0-1 12D 30 1000 500 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. 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 X no (ifyes. complete Part B) Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall;No: SampleCoflectetl;,.;r;'_ rrio/,dd/yr T' ,"-!Oil`,--d`Grea"se, mg/L" T55;. mg/L. : --pH, Standard units New;Motor.OWUsage, Ahnual..average;gal/mo- Benchmark 30: 100 6r'504 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 �IU 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 S WU-249 Last Revised: October IS 2012 *FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1.13EQUIREMENTS. 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 X 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 161.7 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." I / 1A) ,,( at ) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/w4/ws/su/Udessw#tab-4 SWU-249 Last Revised: October 18, 2012 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted 6-28-2016 CERTIFICATE OF COVERAGE NO. NCG 06 02 41 FACILITY NAME Liggett Group LLC COUNTY Alamance PERSON COLLECTING SAMPLES Vince Fallon LABORATORY ENCO Lab Cert. # 591 & 442 Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2016 FACILITY ACTIVITIES INCLUDE (check all that apply): ❑ use/process meats ❑ use animal fats/byproducts DISCHARGING TO SALTWATERS? ❑YES X NO PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall z 5 8" or n No discharge this period3 Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal Coliforml, Colonies per 100 ml Enterococcil, Colonies per 100 ml Benchmark - 100 or 504 Within 6.0 — 9.0 120 30 1000 500 001 06/07/16 24 5.9 29 <2.40 002 06/07/16 18 6.5 27 <2.40 _ 003 06/07/16 9.7 6.6 54 <2.40 I VL JUL 0 1 Only applies to facilities that use/process meats. L ALES ZThe total precipitation must be recorded using data from an on -site rain gauge. DWR ACTION 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 X 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 504 6.0 — 9.0 - 1 Only applies to facilities that use/process meats. ZThe 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 (if yes. complete P` _aft':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 OUTFALI_ 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 ANY ONE OUTFALL? YES ❑ NO X IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one cry 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." re of Permittee) "?7—Zv, -2a/G (Date) Additional copies of this form may be downloaded at: htto://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 5NVU-249 Last Revised: October 18, 20 t2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 RECEIVED Date submitted 10/15/2015 OCT 2 6 "lGi5 CERTIFICATE OF COVERAGE NO. NCG 06 02 41 SAMPLE COLLECTION YEAR 2015 FACILITY NAME Liggett GroupLLC FACILITY ACTIVITIES INCLUDE (check all that apply): CENTRAL FILES DWR SECTION COUNTY Alamance ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES Vince Fallon DISCHARGING TO SALTWATERS? ❑YES X NO LABORATORY ENCO Lab Cert. # 591 & 442 Part A: Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event roinfol! z 1.3" or ❑ No discharge this period3 Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal Coliform', Colonies per 100 ml Enterococci1, Colonies per 100 ml Benchmark - 100 or 504 Within 6.0 — 9.0 120 30 1000 500 001 09/25/15 29 6.05 21 <2.40 002 09/25/15 3.8 6.16 23 <3.03 003 09/25/15 4.6 6.94 60 <2.40 F 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. 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 X no (ifyes, complete Part B) 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 504 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 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. S W U-249 Last Revised: October 18, 2012 Page I of 2 ir- *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 li SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO X 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." of Permittee) _/9-ccr ;zois- (Date) T Additional copies of this form may be downloaded at: httpa/portal.ncdenr.org/web/Ag/wslsu/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 Quality General Permit No. NCG060000 Date submitted 7/22/2015 _ NECEI V ED CERTIFICATE OF COVERAGE NO. NCG 06 02 41 FACILITY NAME Lieeett Groun LLC COUNTY Alamance PERSON COLLECTING SAMPLES Vince Fallon LABORATORY ENCO Lab Cert. # 591 & 442 Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2015 AUG 0 4 2015 FACILITY ACTIVITIES INCLUDE (check all that apply)-T-RA! F1� ❑ use/process meats ❑use animal fa.tsJ;b p`r&IuNN DISCHARGING TO SALTWATERS? [:]YES ®NO UN PLEASE REMEMBER TO SIGN ON THE REVERSE 4 i Total event rainfall z or ® No discharge this period Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal.ColiformI, Colonies -per 100 ml Enterococciz, Colonies per 100 ml Benchmark - 100 or 504 Within 6.0 — 9.0 120 - 30 1000 SOD 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. 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. 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. 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. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. SWU-249 Last Revised: October 18, 2012 1 page of 2 4* *FOR PAP-1 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 ANY ONE 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 L within 30 days of receipt of the lab results (or at end of monitoring period in the case o "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: "1 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." ure of Perrnittee) .13 -1214 -Zdls - (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wg/ws/suZnpdessw4tab-4 S WU-249 Last Revised: October 18, 2012 Page 2 of 2 SEMI -ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water QualityGeneral Permit No. NCG060000 �j 6 �;� Date submitted 9dlIf JUL, 14 2014 CERTIFICATE OF COVERAGE NO. NCG 06 02 41 SAMPLE COLLECTION YEAR 2014 CENTRAL FILES FACILITY NAME Liggett Group LLC FACILITY ACTIVITIES INCLUDE (check all that apply): DWQ/80G COUNTY Alamance ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES Vince Fallon DISCHARGING TO SALTWATERS? ❑YES X NO LABORATORY EN Lab Cert. # 591 & 442 Part A. Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall z or ® No discharge this period' Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L FecallColiforml, Colonies per 100 nil Enterococci�, Colonies -per 100 ml Benchmark - 100 or 504 Within 6,0 — 9:0 120 30 1000 500 001 002 003 i Only applies to facilities that use/process meats, zThe 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 X 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 504 6.0 — 9.0 - (if yes, complete Part B) 2 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. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. SWU-249 Last Revised: October 18, 2012 Page ] of 2 .. *l"OR 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 ANY ONE OUTFALL? YES ❑ NO X 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: DWQCentral 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 Permittee) (Date) Additional copies of this form may be downloaded at: http://portal.Ecdenr.oMZweb/wq/ws/su/npdessw#tab-4 S WU-249 Last Revised: October 18, 2012 Page 2 of 2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 CERTIFICATE OF COVERAGE NO. NCG 06 02 41 FACILITY NAME Liggett Group LLC COUNTY Alamance PERSON COLLECTING SAMPLES Vince Fallon LABORATORY EN Date submitted 1/5/2014 Lab Cert. # 591 & 442 Part A: Stormwater Benchmarks and Monitoring Results RECEIVED SAMPLE COLLECTION YEAR 2014 Mary x 410.7 C FACILITY ACTIVITIES INCLUDE (check all # ENT that apply): OW �RAL FILES ❑ use/process meats ❑ use animal fats/byproductsSECrl4N DISCHARGING TO SALTWATERS? ❑YES X NO PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall 2 0.125' or [:]No discharge this period3 Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal Coliforml, Colonies per 100 ml EnterococciI, Colonies per 100 ml Benchmark - 100 or 504 Within 6.0 — 9.0 120 30 1000 500 001 12/09/14 3.2 6.07 19 <2.80 002 12/09/14 2.0 6.55 460 3.93 003 12/09/14 52 6.70 37 <2.40 i Only applies to facilities that use/pracess meats. Z 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, r" Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes X no (ifves, complete Part B) 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 504 6.0 — 9.0 - 1 Only applies to facilities that use/process meats. Z 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. ASee General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. SWU-249 Last Revised: October 18. 2012 Page 1 of .*FOR PART A.AND PART B MONITORING RESULTS: • r A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART it 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 X 1F 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" re orts within 30 days of receipt of the lab results or at end o monitoring period in the case a "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. 1 am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." turg6of Permittee] e?`J-44 — Zot� (Date) Additional copies of this form may be downloaded at: htttp:/�portal.ncdenr.org/web/wows/su/npdessw#tab-4 SWU-249 Last Revised: October 18, 2012 Page 2 of 2