NCG060288_MONITORING INFO_20190702

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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
0 HISTORICAL FILE
O�MONITORING REPORTS
DOC DATE
❑ ��� b��a
YYYYMMDD

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000
Date submitted (D- � f q A7
CERTIFICATE OF COVERAGE NO. NCGO60 a d
FACILITY NAME (3D I A((f � Lc -(-
COUNTY D ,,?j (J '
PERSON COLLECTING SAMPLES Ja Z2,1 1
LABORATORY fNy'idrh i✓ / /44,, abCert.ft <<
Part A: Stormwater Benchmarks and Monitorine Results
SAMPLE COLLECTION YEAR
SAMPLE PERIOD ® Jan -June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS
❑ORW ❑HQW ❑Trout ❑PNA
[_]Zero -flow ❑Water Supply ❑SA
,Other 4,/aU ./c �2✓
JUL 0 2 16CILITY ACTIVITIES INCLUDE (check all that apply):
CENTRAL FILES ❑ use/process meats ❑ use animal fats/byproducts
DWR SECTION
PLEASE REMEMBER TO SIGN ON THE REVERSE a
Tntnl avant rninfnll Z 0.1 i , F-1 Al- 4;c Phn H,;, .. ;—A3
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
-
100or504
Within6.0-9.0
120
30
1000t
Soo,
Parameter Code
-
C0530
00400
00340
00556
31616
61211
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2
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v uy nPpnes io iacwnes 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.
4See 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 no
Permit Date: 11/1/2018-05/31/2021
(if yes, complete Part B)
SWU-249, Last Revised 11/5/2D18
Page 1 of 2

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000
Date submitted 41- 21N 67
CERTIFICATE OF COVERAGE NO. NCG06 0 a _1_Y
FACILITY NAME 1 Q,X L/4��4r rcO )S LL C
COUNTY T), Alw
PERSON COLLE ING SAMPLES Sare7 , � ZZ (/
LABORATORYF-O%vdww,rV Lab Cert. # 9Y
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR � U
SAMPLE PERIOD © Jan -June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow [:]Watersupply ❑SA
Other
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall z ;?, o or n No discharge this neriod3
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 504
Within 6.0 — 9.0
120
30
10001
500'
Parameter Code
-
C0530
00400
00340
00556
31616
61211
' 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 t no (if yes, complete Part B)
Permit Date: 11/1/2018-05/31/2021 SWU-249, Last Revised 11/5/2018
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month
Outfall No.
Date Sample Collected
(mo/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/L4.
Parameter Code
-
46529
NCOIL
00552
Cb530
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 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 DEMUR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR including all "No Discharge" reports within 30 days of receipt of the lab results for 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, 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."
Signature of Permittee
Permit Date: 11/l/2018-05/31/2021
(,-ZY/�
Date
SWU-249, Last Revised 11/5/2018
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