NCG030567 DMR SW (13)

1
Semi-annual Stormwater Dl'charge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted /-3/—/' _
CERTIFICATE OF COVERAGE NO. NCG03Q J L(2_. /
SAMPLE COLLECTION YEAR cq°/
FACILITY N. E Cry--" p►11 A1C-- SAMPLE PERIOD ❑Jan-June D July-Dec
COUNTY or E 'Monthly1 .J ()ix2 11021 (month)
PERSON COLLECTING SAMPLES i I'Y1es
.i7t ge, DISCHARGING TO CLASS ❑ORW DHQW Trout ❑PNA
LABORATORYTlRp. ,,��°Lab-'t,-c,Lab Cert.# 7�i ❑Zero-flow Water Supply DSA
Comments on sample coll&tion or analysis: Other C I5 C_
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
Part A:Stormwater Benchmarks and Monitoring Results
No discharge this period?2
Date Sample 24-hour rainfall pH, Non-Polar O&G/ Total Toxic
Outfall No. Collected) amount, Total Suspended Solids Standard units Copper Lead Zinc Total Petroleum Organics
, (mo/dd/yr) Inches3 Hydrocarbons
Benchmarks===> - - 100 mg/L or 50 mg/L4 6.0-9.0 0.007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L
per, Za ®r_-_
— —,a k v L.LI
Fk8 072017
_ .n. "„ u QUAL f 1 Y
SiOrM ,ATP 2.DE.n,,,FT,..-
1 Monthly sampling(instead of semi-annual) must begin with the second consecutive benchmark exceedance dor the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall,you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on-site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit,Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations,manufacture semiconductors, manufacture
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 metal finishing use the definition as found in 40 CFR 433.11;for semiconductor
manufacture use the definition as found in 40 CFR 469.12;for electronic crystal manufacture use the definition as found in 40 CFR 469.22;and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date:11/1/2012-10/31/2017 SWU-245,last revised 10/25/2012
Page 1 of 3

Note: If you report a sample value in excess of the benchmark,you must implement Tier 1, Tier 2,or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
© A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
o 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
e 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 REGIONA,LQFFICE? yES NO❑
REGIONAL OFFICE CONTACT NAME: rrkri l(Jj ?I1�
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,North Carolina 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."
rov
0 7
(Signature of armittee) Date)
Permit Date:11/1/2012-10/31/2017 SWU-245,last revised 10/25/2012
Page 3 of 3