NCG060351_MONITORING INFO_20191107

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑ HISTORICAL FILE
EY MONITORING REPORTS
DOC DATE
❑ I -7
YYYYMMDD

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000
Date submitted S _�� —/ I (i RECEIVED
NOV 0 7 2019
CERTIFICATE OF COVERAGE NO. NCG06 0 -3 SAMPLE COLLECTION YEAR ✓1-O /��-----CENTRAL FILES
FACILITY NAME /1.'1`:'�n / ti.t:. l ] �'l %�! •. c' /i 'ram"` SAMPLE PERIOD ❑ lan-June ❑d lu y-Dec DWR SECTION
COUNTY �,.64 4 ✓1 or ❑ Monthty5 (month).
PERSON COLLEC�ING SAM>PLES—� &I��(;c _ d2'PNA
LABORATORY P/ i+- Ld.l) LabCert.# /yam:- DISCHARGING TO CLASS ❑Oero-flo�wJH❑Wat rsupplyu❑IS
❑Other
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
r,.«,.r „•,..,,f .-i,,r„u I /-1. U1 nr (—I No dischorne this period'
Part A: Stormwater
Benchmarks ano
monitoring ttesuns
TSS,
COD,
•-• ....,-
Oil and Grease,
—
Fecal Coliform,
Enterococci,
Outfall No.
Date Sample
Collected, mo/dd/yr
mg/L '
pH,
Standard units
mg/L
mg/L
Colonies per 100 ml
Colonies per 100 rill
Benchmark
-
100 or 504
Within 6.0— 9.0
120
30
1000
500'
Parameter Code
C0530
00400
00340
00556
31616
61211
�%G-�L�/
r�
' Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from in 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 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
lwonthly 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 (if Ycs, complete Part B)
SWU-249, Last Revised 11
Permit Date: 11/1/201Page 1 of .8-OS/31/2021 g1 of 2
2

cc �,l . f .,�u, motor nil/month
Part B: Vehicle Maintenance
Outfall No.
Area iviomtonng Kesuiu:
Date Sample Collected
(mo/dd/yr)
umy w.
24-hour rainfall amount,
Inches'
- --- a-• --- . ---
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/L"
Parameter Cade
-
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 PAR I'll SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMEI IiR AT ANY ONE OUTfALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR including all "No Discharge" reports, within 30 days o ,,c,,p
j_o the lah results (or at end of monitoring_period in the case
of "No Discharge" reports) to:
Division of Water QI
Attn: DWQ Central 1617 Mail Service CRaleigh, NC 27699-
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 submiftinl; false information, including the possibility of fines and
imorisonment for knowing violations." ,
ll is
Date
Permit Date: 11/1/2018-05/31/2021
SwU-249, Last Revised 11/S/2018
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