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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V C� OIDU I L
DOC TYPE
❑HISTORICAL FILE
�1 MONITORING REPORTS
DOC DATE
❑ C�u r r 0) I% 3
YYYYMMDD
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Q ality General Permit No. NCG060000 RECEIVED
Date submitted Z
CERTIFICATE OF COVERAGE NO. NCG060 O O O SAMPLE COLLECTION YEAR 20kc'
FACILITY NAME �,yC .,��� p-t�aS �}L, LLC . - -- -
CO U NTY `_ -(S o r, - -- - -- -
PERSON GO•i.LEt
LABORATORY- -
Part A: Storrnwater Benchmarks_and Monitoring Results.....r_
FEB 0 3 2019
Cir!~:1`%vr�l_ FILES
FACILITY ACTIVITIES INCLUDE (check all that apply): DVrVR SECTIONN'
D use/process meats ❑ use animal fats/byproducts
DISCHARGING TOSALTWATERS? ❑YES ONO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total,event rainfall' or ❑ No discharge this period3
'Uutfall IVo'"
'Sapp le'Cnliected,
�rTSS,� �`
pM; 1
darn units.7"
COD,
Trig/L "
911, anii Grease, _
,m8/L`:
r Fecal Coliform
Colonies pe'r 10U nil
Enterococci ,
'Colonies der lOU mi
s = atl
:;7 00:or50 q
With€n:(i:0 i. _ 9.0`r
,f� 2U
;30 c ,
lOQO ,4.
S00
Only applies to facilities that use/process meats.
z The total precipitation must be recorded using data from an :ony'sifi -rain gauge.4
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.ti'iah;55'gallotis of new motor oil per month? Q yes 17 no
Part B:.Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Uutfall No.,
L.w:r •, i
f� Sample�Collscted;
x.. 'Y. /- l b....4.F3'1
tip. ma/•dd/Yr: ..r
w��FOiI and Grease,
�J '� k'-; e
.: �, �� ml;/ "? . �-. v
: ,iSaS„
r 6;' h - Lw .' �M 4. _.:J.
,,, ..1L -: nsg/L €
pH, ,'
.. .. ,- t
i+ Standard_units :
New Motor.. Oil: Usage,
.'
;.�:Annuai:airerage.gal%mor;,
BenChiriark r
�.;- 30f `' ,,
100?ory5t?
6.0 " 4.0
only'applies "t6�faciliiies'that use/process'meats:-
xThe total'precipitatiori mustlbe recorded using data from an on -site rain gaugi-. '
3 For sampling! periods, with n-o.discharge atand± outfalls,=you must still.submit this discha`rge!m6n1t6ring report with -a checkmark here.
°See. General:: Fermit,text, :Tab1e_3,;identifying.the especially sensitive receiving water classifications where the more protective benchmark applies
(if yes, complete Part B)
SWU-249 Last Revised: OCLOb er 18. 2012
pace I of 2
*FOR..PART. A AND,PART B.MONITORING.RESUI:TS:. - _.
•• .-A-BENCHMARK-EXCEEDANCE TRIGGERS -TIER ].REQUIREMENTS:' SEE. PERMITIPAR7 II SECTIONIB
` • 21EXCEEDANCES IN'NROW-FOR THE SAME PARAMETER AT-THE'SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
•.'j'.WtFili -'i{AS YOORT4CILITY HAD 4.OR MORE BENCHMARK EXCEEDENCES FOR.THE SAME PARAMETER AT- ANY ONE,OUT YES [] NO.®
IF_YES,.HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES r] NO Q--
REGIONAL OFFICE•CDNTACT NAME: _
-Mail-an original and one,copy of this DMR, includes all "No.Dischar e" re orts -within k slays of,recelpt o -tN-'1db.resu1ts (or at end o .
monitorinaperiod._in the case'of E"No �Drscharge"'reports) to: s
_ >>. DNision-of Water -Quality
Attn: DWQ,Central Files
Lj617 Mail.Service.Center. .
Raleigh„ NC.;27699-1617.
YOU MUST•SIGN THIS CERTIFICATION FOR ANY 1NF0RMAT10N'REP0RTEDr"`
"I certify, under penalty of law, that this document -arid all attachrri&'6ts were prepared dn`deriiiy'di'rection 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
tperson or persons who manage the system, or those persons.directly,responsible,for gathering the inforrnation,.tiie information submitted is,
to the best of my k6o'wledge and belief, true, accurate;'and complete. I am aware'that there; are `signtfjcant' penalties for submitting false
information, inciudin t -p ssibiiity of fines and imprisonment.for"knowing violations - -
(Signatu of Perrnittee)
Addifional copies of this form may be downloaded,at: h'ttp:[/Egrtal.n_cdenr'.org/web/vug/wlsu/npdessw#flab-4
SWU-249 . i } Last Revised: O rr 18, 2012
,?age's- 1' 2