NCG060100_MONITORING INFO_20191209

FR b
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
�/C G b 00
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ la O
YYYYMMDD

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Resources General Permit No. NCG060000
Date submitted 1,2-,2- //9
CERTIFICATE OF COVERAGE NO. NCG06 0 6) fL C SAMPLE COLLECTION YEAR /G 9
FACILITY NAME k-s<; (%r�v lam, Ll�. .��� l�=1� FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY ss.� use/process meats use animal fats/byproducts
/byproducts
PERSON COLLECTING SAMP.L�E/$ /yam �/1�� ~� DISCHARGING TO'SALTWATERS? 21U0
LABORATORY ��_'%: n..J ! ,IX---h/SLab Cert. ft 4�1) d// RECTI v 20
DEC Q @_Q*18 REMEMBER TO SIGN ON THE REVERSE 3
Part A: Stormwater Benchmarks and Monitoring ResultsIZALTotol event rainfall z �, S, or ❑ No discharge this period'
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD, "
mg/L
°'v Oil�dd Gi�ase,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
100or50
Within 6.0 - 9.0
120
30
1000
500
/1. G
4S
i
Z _S
// -
/
' Only applies to facilities that use/process meats.
2The 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 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes no (if ves, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 50
6.0 - 9.0
-
' Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
'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 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SWU-249. _ _ _ -- -- _ Last Revised: October 18, 2012
- Page I of 2

*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 B.
• 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 REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
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 Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"1 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."
Permittee)
/) -,,2-i�
(Date)
Additional copies of this form may be downloaded at: http://portal.rtcdenr.org/web/wq/ws/su/npdesswgtab-4
SWU-249 - — - -
Last Revised: October 18. 2012
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPOR
for North Carolina Division of Water Resources General Permit No. NCG060000
Date submitted /� 12 / 1
CERTIFICATE OF COVERAGE /NO. N0006 U 0 ,9 0 SAMPLE COLLECTION YEAR ;21111
FACILITY NAME ly�s s l ''i� s••� /� - �« ��� �as /ii� FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY G use/process meats use animal fats/byproducts
PERSON COLLECTING SAMPLES, /u I ,,�— �i�il DISCHARGING TOSALTWATERS? YES Q OO
LABORATORY %..i.w lw Je:/ Lab Cert. It / C9G v/ IV j
PLEASE REMEMBER TO SIGN ON THE REVERSE
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall 2 /%,-!;�•or n No discharge this period?
Outfall No.
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 SO
Within 6.0-9.0
120
30
1000
Soo
/ iS /
ss
mil• '
Y
S
lf-At-
' Only applies to facilities that use/process meats.
2The 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.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes no (if yes, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaeine > 55 eat of new motor oil/month.
Outfall No.
Sample. Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100or50
6.0-9.0
-
' Only applies to facilities that use/process meats.
2The 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 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
- SWU-249- _. _ _ _ __ - _ - _- -- _ - --_ -- - -_ -- - - -- - Last Revised: October 18, 2012 ' -- -
Page I of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS, SEE PERMIT PART II SECTION B.
C 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 REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
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 Resources
Attn: DWR 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 violations."
of Permittee)
(Date)
Additional copies of this form may be downloaded at: htl2://portal.ncdenr.2rglweblwg/ws/su/npdesskAj#tab-4
SWU-249 Last Revised Oct ober I8, 2012
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR) / SPPP Annual Update DATA REVIEW FORM
Calendar Year
Individual NPDES Permit No. N
Certificate of Coverage (COC) No. N
or
This monitoring report summary of the calendar year should be kept on rile on
n--site with the facility SPPP.
Facility Name: 's "K_ z (O - "e 'aw C «•s ��"-�'�
County:
Phone Number: yk fG7- Gig a- Total no. of SDOs monitored Z
Outfall No. I
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No (�
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No [�
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No
Parameter, (units)
Total
Rainfall,
inches
�ys�G
rws�G
�3/L
Benchmark
N/A
/,LD
3o
///f
Date -Sample
Collected,
mmldd/yy
w...
- -
--SWU-264 - Generic Annual DMR
- _ -_ - - --- -:.-- - - - - - -- - Last revised 6/0112018

Additional Outfall Attachment
Outfall No. �Z_
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No [a'
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No ❑/
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No 0,-�
Parameter, (units)
Total
Rainfall,
inches „u/GS/L
Benchmark N/A /vo 6-1 w /4///�
Date Sample s N a M
Collected
mm/dd/YY -
-/)-/5 0 •}" SG .tf
/I zr. >/ 11 Si' ..3 71e, 3 - f.Z it//L
_ —
_ - SWU-264 -Generic Annual DMR -
Last revised 6/012018

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 impr' ment for knowing violations.".
Signature 4/ �
Date _ h-,2-/I
For questions, contact your local Regional Office:
DEMLR Regional Office Contact Information:
ASHEV[L'liEsRECIONALOFFICE
FAYETTEVILL'E=REG[ONAL".OFFICE
_ ,
M00RESV►LLEIREGIONALOFFICE
i
2090 US Highway 70
225 Green Street
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
RAliEIGHwREGIONAL''OF.FIGE
WASH INGTONREGIONAL''OFF.TCE
`'ILMLNGTONREGIONA`U;OFFICE
3800 Barrett Drive
943 Washington Square Mall
127 Cardinal Drive Extension
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
LVSTON.-SAGEMaREGIONAL$OF*ICE
CENTRAL`OFFICE
1617 Mail Service Center
450 Hanes Mill Rd, Suite 300
Winston-Salem, NC 27105
Raleigh, NC 27699-1617
[phone]
[phone]
_ - - SWU-264- Generic Annual-DMR
Last revised 6/01/2018