NCG060009_MONITORING INFO_20191216

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑ HISTORICAL FILE
$l MONITORING REPORTS
DOC DATE
❑ a b� I I a (�
YYYYMMDD

W
STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources
General Permit No. NCG060000
Date submitted
CERTIFICATE OF!COVE AGE NO. NCG`06QQ0 1 + SAMPLE COLLECTION YEAR
FACILITY NAME F'T_S tn�rA; SAMPLE PERIOD ❑ Jan -June July -Dec
COUNTY'Q,,11^,, - tsn or ❑ Monthly' (month)
PERSON COLLECTING SAMPLES
LABORATORY Tat-- Lab Cent. It AKfr-O J Gii 3i DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
[]zero -flow ❑Water Supply ❑SA
Other
FACILITY ACTIVITIES INCLUDE (check all that apply):
Z use/process meats ❑ use animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall' . J or n No discharge this period'
Outfall No.
Date 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
Enterococci,
Colonies per 100 ml
Benchmark
100 or SW
Within 6.0-9.0
120
30
1000'
Soo,
Parameter Code
C0530
00400
00340
00556
31616
61211
_ � _
�.•'
,O
5 L
3 to
Only applies to facilities that use/process meats.
'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.
'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 Z no (if ves, complete Part B(
Permit Date: 11/l/2018-05/31/2021 SwU-259, Last Revised 11/5/2018
RECEIVED Page l of
DEC 16 20I9
W i SFC-rir) .

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging> 55 gal of new motor oil/month.
Outfall Na.
Date Sample Collected
imo/dd/yr)
24-hour rainfall amount,
Inches'
New Motor Oil or
Hydraulic Oil Usage
Non -Polar O&G/Total
Petroleum Hydrocarbons
Total Suspended Solids
Benchmarks
-
-
-
15 mg/L
100 mg/L or 50 mg/N
Parameter Code
-
46529
NCOIL
00552
COS30
Footnotes from Part A also apply to Part B
'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 It SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO m
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Moil an original copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the Icb results for at end of monitoring period?n the case
of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
"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 syst those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and
belief, true, ac rate, nd c mplete. aware that there are significant penalties for submitting false information, including the possibility of fires and
im prisonmen for kno in vi
Signature Permittee Date /
Permit Date: 11/1/2018-05/31/2021 SWU-249, Last Revised 11/5/2018
Page 2 of 2