NCG060209_DMR_20210106

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000
Date submitted A— 6-- &A
CERTIFICATE OF CO RAGE NO. NCGO6O_—a1 O_� SAMPLE COLLECTION YEAR ao ao
FACILITY NAME OLW �eea
COUNTY � SAMPLE PERIOD ❑ Ian -June [duly -Dec
PERSON COLLECTI G SAMPLES
or El Monthly' (month)
LABORATORY
Lab Cert. p
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Watersupply ❑SA
Mher Ojcks-ss_CTSW
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats use animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
No F-C O ejej
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall I or o discharge this period'
ouefall No,
U4te-Semple ,
Gollmcted, mo Odty4,er100
Ti$
H'
i �
Cpf� I
uql>N d,i3� tiFp$a
' � p y
ptlopl pllfgrm,
mk
Enteroeoecl,
Colonlor er too:mC
Benchmark
$00b
Parameter Code
'sQ 90,=.`<
"'=C
i40 '''r00
40„�,"
,•GdJl�tl, +�r•--914918
"..81211.
1 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 ❑ no (if es complete Part B)
Permit Date: 11/1/2018-05/31/2021 SWU-249, Last Revised 11/5/2018
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Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No,
Date Sam` Is Collected4t�our
. p:
lm%dd/yrj-`
ral r `
n11h��
:.x�, , t.,
Inch+
o ,o
Nawl:,
,; ..r
, . lyr+its�it?.i)�ae r
a o otal
�patralgum;Nydrearb4ns
Total Suspended Solids
Benchmarks:
.: -
s 5:.." ' : �Ki
r �; i , ,
, ;r �, g/I, :
S:f11
100 mg/L.or SO mg/V
Parameter Code
48gz
COS30
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 S TION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCE FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES NO C]
IF YES, HAVE YOU CONTACTED THE D MLR REGIONAL OFFICE? E 19 291-N
REGIONAL OFFICE CONTACT NAME: 1�S — x q
Mai! an orlainal copy of this DMR, lncludlna all "No Discharae" 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 viola�,ions.
Signature of Perfnittee
C
Date
Permit Date:11/1/2018-05/31/2021
SWU-249, Last Revised 11/5/2018
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