NCG060348_MONITORING INFO_20190913

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCG M �y
DOC TYPE
❑ HISTORICAL FILE
❑MONITORING REPORTS
DOC DATE
❑ ��� O /3
YYYYMMDD

CERTIFICATE OF COVI
FACILITY NAME Af
COUNTY Pf-I
PERSON COLLECTING
LABORATORY__
STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000
Date submitted
NO. NCG060 S 4 J
Lab CeR
b [. C
SEP 13 2019
CENTJ;tqL F
DYm SECT ON
Part n- Ctnrmwntar Renrhmarks and Monitorine Results
W
SAMPLE COLLECTION YEAR c V ICi
SAMPLE PERIOD ❑ 1an-June ❑ July -Dec
or ® Monthly' i 11))t (month)
DISCHARGING TO CLASS ❑ORW []HQW ❑Trout ❑PNA
Zero -flow ❑Water Supply ❑SA
Other C I' W
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' or X 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
-
100or504
Within 6.0 — 9.0
120
30
10003
Soo'
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.
4See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
sMonthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
'uo Ckoplimb)-e &AtwhurrI� no Wo'a- oil I)OV6 A igljSi J016i
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? ❑ yes & 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.
C0530
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 DEMLR RE IQNAL OFIF,ICE? YES M NO ❑
REGIONAL OFFICE CONTACT NAME: � f6l ) I J a `� wL
Mail an original 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 Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, INC 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
re of
9 II
Date
Date:
SWU-249, Last Revised 11/5/2018
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