NCG080198_DMR_20200430

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STORM EVb i' CHARACTERISTICS:
Date (first event sampled)
Total Event Precipitation (inches):
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: If you report a• sample value in excess of the benchmark, you must implement Tier 4 Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
0 A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
0 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
0 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:
Mai1 an on final and one co-ov of this DMR includingall "No Discharge" orts within 30 da s o recei t o the results or at end o monitorin eriod in
the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central. Files.
1617 Mail Service.Center. '
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
N 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 proper ather and evaluate the information. submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly res slble for gath ring t e Infor tion, the information submitted Is, to the best of my knowledge and belief, true, accurate, and complete. 1 am aware that
there are fig ificaniipena for ubmitt' false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
(Date)
Additional copies of this form may be downloaded at: http:Hportal.ncdenr.org/web/wa/ws/su/nodessw#tab-4
SWU-250
last revised October 25.2012