NCG060185_MONITORING INFO_20191204

VV
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V C� bbo I � 5
DOC TYPE
❑ HISTORICAL FILE
IWONITORING REPORTS
DOC DATE
❑ a b� a D /
YYYYMMDD

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Resources General Permit No. NCG060000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG06 0 f $ SAMPLE COLLECTION YEAR 7of
FACILITY NAME �.#n( r grMS It < FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY t _ use/process meats ❑ use animal fats/byproducts
PERSON COLLECTI G SAMPLES -3ere.^,y 130�jt: x DISCHARGING TO SALTWATERS? []YES 0.46
LABORATORY IYler +ems% LabCert.# /f.,S
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall z .58 or n No dischorop this nprinria
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,.
Standard units
COD,
mg/L
Oil'and Grease,
MOIL
Fecal Coliform ,,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100or50
Within 6.0 — 9.0 -
120
30,
1000
Soo
Dol
/0-/(o-ao1
/65
Co.
1 a Ll
< 5
7 000
rlTT�i\{�I
r 9 9
. Only applies to facilities that use/process meats. CENTRAL FILES
2 The total precipitation must be recorded using data from an on -site rain gauge. DWR SECTION
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 QRno (if yes, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 eal 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.
a 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 _ LaszRevised: 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 includinu 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_Gentral 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 forgathering 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 t ssibility of fines and imprisonment for knowing violations."
(Si gnatur Perm ee) ( ate)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.org/web/wq/ws/su/npdesswHtab-4
SWU-249 _ _ _ _ _ _ _ Last Revised:. October 18, 2012
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