NCG030436_DMR_20210430

Stormwater Discharge Monitoring 9±port
for North Carolina Division of Energy,. Mineral and Land Resources General Permit No. NCG030000
Datesubn'iitted L%/!gr),2
CERTIFICATE OF COVERAGE NO. NCG03 6 Q 3l0
FACILITY.NAME rrt-C iiFl C _
COUNTY i : '': K r
PERSONCOLLECTINGSAMPLES__�;___ -
LABO
Comr
Lab Cert. tf
or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE. COLLECTION YEAR
SAMPLE PERIOD [] JanduneF]July-Dec
or E3`M0nthly, mler.b-, (month)
DISCHARGING TO CLASS ❑ORW []HQW []Trout ❑PNA
�E���tiCD ©Zero -flaw []Water Supply []SA
t/ C ❑Other
MAY 10 2021
CEN I kAL FILES PLEASE REMEMBER TO.51GN ON PAGES Z.AND/OR 3 4
DWR SECTION
❑v No discharge this period?-'
Outfiall No.
bate Sample
Collected'
(mo/dd/yr)
24-hour.
amount,
Inches3
Total Suspended Solids
pH,
Standard units
Total Copper
TotaYLeaA
Total Zinc
Non -Polar 0&G/
Total Petroleum
Hydrocar)ions
TotalToxic
Qrganicss
Benchmarks
-
i00 mg/L or 50 mg/O
6.0 —9.0
0.010 mg/L
0.075 mg/L
0.126 rng/L
15 mg/L
1 mg/L
Parameter Code
-
46529
C0530
0040.0
01219
01051
01094
06552
78141
Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance:for the same parameter at the same 4utfall.
2 For sampling periods with no discharge -at. any single outfali, you must still submitthis'discharge monitoring report with a checkmarkhere.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattendedsites may be eligible for a waiver:of tl*rain gauge requirement:
°.See General Permit, Section B, Table 1 to identify the especially sensitive receiving water classifications where (lie more protective. benchmark. applies.
3 Total Toxic Organics sampling'Isapplicable ohiyfor those. fadlities.which pgrform. metal finishing operations, manufacture semlconductors, manufi CtUte
electronic crystals,.or. manufacture.cathode ray tubes. For purposes of this permit the definition'.of Total Toxic'Organics,is that definition contained In the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for meta) finishing use the definition as found in 40 CFR 433.11,, for serriiconcluctor
manufacture use the definition as found in 40 CFR 469.12; for electronic,crystal manufacture use the'deflnition as found in 40 CFR 469.12;,and.for cathode ray
tube. manufacture use: the definition found in 40 CFR 469.31).
Permit Date: 11/1/2018-05/31/2021 SWU.245,last re6ised 11/1/2018
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FacUlties that Incor p* ovate a solvent. management plan into'tlie 5torrriWater Pollution PreVentibn Plan, may so certify; and the. requirement, for TTO monitoring
may be waived. The-solvent.rnanagernent plan shall include a list of the total toxiq or compounds used and the other elements listed In the General
Permit. For those facilities electing .to employ, -the.TTO monitoring waiver, the dischaeger.*shall sign the following certification statement:
"gasod.-upon my inquiry of the person or persons directly responsible for-managibg compliance with the:permit'-rrion1tor1hg requirement for total.toxic organics
(TTO),.l certlfy that -to the best of my knowledge and belief, no dumping• of coneentreted toxic orgariics-into the stormwater or areas which are-expo�ed to rainfall or
stor'_mwater. runoff ,has:occu.rred.sirice f)ling.the.1ast discharge "--monitoring report. I furthor certify. that this facil.(ty is implerrtent'in .the -all the.provisions.of the
solvent management plan iric(uded-.ln tiie:Storrriwater. Pollution Preventlon Plan."
Io
Name (Printiname)
IN
ollivil-P12,1 d 06-LU elacl
Title (Print title)*
�) U.7- )
Signature. Date
Note..: Results must be reported in numerical format. Do not report Below Detection- Lirnit, BDL, <PQL,. Non -deflect, ND, or-other•similar non numerical
format. When results are below the applicable limits,. they must -be reported in'the forrriat, "<XX ma/L",:whpre XX Is the numerical value :of the detection.
limit, eeporting limit,,etc.•ih rrig/L.
Note:,.lf,you r'eporta-;sa►riple value ih eXcess of -the bertchmar.k, you must/mplement.Tier 3, Tier. 2, vr-Tier. 3 response's. See .General Permit text.
Part B: Nehicle Maintenance Area Monitoring Results: -only for facilities averaging >:S5.gal of new oil perm©nth.
- J]
No- discharge -this period?2
Outfail�No:
Date Sample Collectecdi
(mo/dd/yr)
24-hour rainfall arnouni;
Inches$
New Motor. Oil or,
Hydraullc Oil Usage
Non -Polar a&G/ Tonal
Potroleum Hydrocarbons
Total Sus ended
p
Solids
Senchmarks
-
-
-
15 mg/L
100 mg/L or 50 mg/0
Parameter Code
46529
MOIL
Ot)552
CO530
Footnotes from Part A also:apply to Part B
Note: If you reporta.sample value in.excess of the benchmark; you:must'irrrplement1ier'l, 7`102, orT'ier3 responses; See Genera!Permit-teXt.
Permit Date: 11/1/2Q'i&05/A1/202'1 5WU-245, last revised 11/i/201g
.Page 10-3

FQR PART A AN© PART R MONlTORING,B95VU
o A BENCHMARK' EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE P>yItMIT PART II SECTION B.
2 EXCEhDAN-CES IN -.-A ROW FOR THE.SAME..PARAME'rER ATTHE SAME.OUTFALLTRIGGER'TIER'2 REQUIREMENTS. SEE PERMIT -PART 11 SE •TION B.
o TIEi;'.j: HAS YOUR FACILITY HAD 4.OR MORE BENCHMARK EXCEEDENCES FOR -THE -SAME PARAMETER. ATANY QNt'OUTFALL? YES MNO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIO * AL OFFICE? YES IVNO ❑
REGIONAL OFFICE CONTACT NAME. 1 . c Va
Mall an origin al c9p
V of this MR, including all "lkq bischar e" re orts . within 30daysgf recei ' t.o the -lab results for at end cif monitorinaperlod.in the
case. of "No Discharge" rfRorts) to.
Divislon -of Water Quality.
Attrj: OWQ Central Files:.
ifi 7 Mail $ervice Center
Raleigh, North Carolina, 2769.9-1617
YOU MUST SIGN*THIS CERTIFICATION'FOR ANY INFORMATION REPORTED:
"I certify, under penalty -of •law,1hat this do'Wrneni and all a.ttpchments were prepared .under -my direction or supervision in '=edance-with a system designed to
assure that qualified persdnnel properly gather and evaluate the'Information submitted. Based on my inquiry of the person or persons who manage the systern,.or
those persons directly responsible for.gothering*tho information, th*e information submitted is, to -the best of my knowledge a.tid belief, true, aceurate,.and complete:.
arn a.ware that there are significant penalties
for submitting false informatibn; including the possibllitY-af fines and- imprisonment for.'knowing vfala.tlons."*
Signature of'Perrriltt
q /.:�() j,;�u�-t
Dad
Permit Date: 11/1/2018-05/31/202.1
5y1l.U-245, last - revised* 11/1/2018:
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