NCG060292_MONITORING INFO_20190718

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCG b( �a
DOC TYPE
❑ HISTORICAL FILE
EY MONITORING REPORTS
�� I
DOC DATE
❑
YYYYM M D D

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Resources General Permit No. NCG060000
Date submitted 1- 6 - M
CERTIFICATE OF COVERAGE NO. NCG06 o a o�, SAMPLE COLLECTION YEAR �O\9
FACILITY NAME 'C,.r o� FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY ® use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES r DISCHARGING TO SALTWATERS? ❑YES ®NO
LABORATORY Lab Cert.# RECEIVED
JUL 18 2019 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results r-MTPAI r1l Fq Total event rainfall I or ® No discharge this period]
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
WR MTIO
mg/L
Oil and Grease,
mg/L
Fecal Coliform ,
Colonies per 100 ml
Enterococci ,
Colonies per 100 ml
Benchmark
-
100orS0
Within 6.0 — 9.0
120
30
1000
Soo
3 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
200 or 504
6.0-9.0
-
Only applies to facilities that use/process meats.
ZThe 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 1 of 2

*FORPART A AND PART &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'NOURTACILITY 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"Discharae" reborts within 30 days of receipt of the -lob results for at end of
monitoring period inahe case of "No Discharae"reports) to:
Division of Water -Resources
Attn: DWR Central Files
1617 Mail Service -Center
Raleigh, NC 27699-1617
YOU MUST S/GN'TH/S 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 the possibility of fines and imprisonment for' knowing violations."
(Signature of Permittee) - - (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wa/ws/su/nodessw#tab-4
SWU-249 Last Revised: October 18, 2012
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