NCG060388_DMR_20210223

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCGO60000
Date submitted
CERTIFICATE OF
FACILITY NAME
COUNTY W N
PERSON COLLECTING SAMPI,yES
LABORATORYUVIbCJY`P.C� Lab Cert. q:
RECO EL.
MAR 01 2021
EN I RAL FILES
DWR SECTION
Part A: Stormwater Benchmarks and Monitorine Results
SAMPLE COLLECTION YEAR - 90011
SAMPLE PERIOD ❑ Jan -June ❑ J ly-Dec
or E[ -Wconthlys month
DISCHARGING TO CLASS ❑ORW ❑HCtW ❑Trout ❑PNA
❑Zero -flow ❑Water Su ply ESA
[}0ther 0�' kiss C.
�W t NS W
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats se animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
el
Tntnl PuPnt rninfnll Z . f 1n nt 71 Al., .. ;. 43
Outfall No,
Data Sample
Gdllactad `mo dd r
m L �;
100 ',; .74
CG15gD
�
a
"f
..;a 0 4 r,.
a�)f
i
ar;,b
1n
p1A>)MIRI11urm,,
mh
8 atd8
6rltarococcl,
Cdlonlea er 400 ml-
81$a1
Benchmark
W.
Pordrneter Code
13
On y app es Lo loci ues ulat userprucess meats.
'The total precipitation must be recorded using data from an on -site rain gauge,
3 For sampling periods with no discharge at any outfalis. 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 Vno (If yes. complete Part B)
Permit Date: 11/1/2018-05/31/2021 SWU-249, Last Revised 11/5/2018
Page 1 of 2

rart o: venicie maintenance
Area monitoring Kesuits:
only Tor Tacuities
averaging > 55 gai oT new motor oii/montn.
Outfall No.
Date 5dm !e Collected
(mo/dd/yr)
Z4•hour roWil �i n nt
1` ,
�n�h+ s
NOW IVlotor.Gli or
`Hydrauttc otlU�ag� '
NonNpolatr t�&G'1'otal
hotrolum, Hydrocarbons
Total Suspended solids
Benchmarks
t •vi.
f. r i •.+
. t •� Sarig%h\-
100 mg/L or 50 mg/L4
Parameter Code
40
NCfll.
00$02
COS30
Footnotes from Part A also apply to Part 8
*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
0 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 DEMLR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR, includina all "No Discharge" reports, within 30 days of recelot 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 27699-1617
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 violafions." ,s
Signature of PeAlttee
Q#-W,Q3
Date
Permit Date:11/1/2018-05/31/2021
SWU-249, Last Revised 11/5/2018
Page 2 of 2