NCG060100_DMR_20210111

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000
Date submitted
hcG6(,.ofov
CERTIFICATE OF COVERAGE NO. NCG`0611Z 0 0
FACILITY, NAME` itcwSaS �' (� s�rn� e li /9 C//ll.54
COUNTY Xwr OSG�✓
PERSON COLLECTING SAMPLES Star
LABORATORYp;rcu,..e..l..i l%a.J,F Lab Cert. #
JAN 2 5 Z021
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR I&;? C
SAMPLE PERIOD ❑ Jan -June July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HCtW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
❑Other
FACILITY ACTIVITIES INCLUDE (check all that apply):
- _❑ use/process-meats P use animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall z e.kf or ❑ 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
-
100 or 504
Within 6.0 — 9.0
120
30
10001
500,
Parameter Code
-
C0530
00400
00340
00556
31616
61211
lea—1 - O
_-.2.7
Ili
e
GS,O
jy
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site 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.
sMonthly 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 S5 gallons of new oil per month? ❑ yes no (if ves, complete Part B)
Permit Date: 11/1/2018-05/31/2021 SWU-249, Last Revised 11/5/2018
Page 1 of 2

O)
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 z
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/0
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.
0 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
0 TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE 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 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, 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 violations."
Permit Date: 11/1/2018-05/31/2021
Date
SWU-249, Last Revised 11/5/2018
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR) / SPPP Annual Update DATA REVIEW FORM
Calendar Year ,,;20,-)6
Individual NPDES Permit No. NCS❑❑❑❑❑❑ or
Certificate of Coverage (COC) No. NCG (❑' M0❑ O❑©
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP.
Facility Name:
County:��
Phone Number: 5«" 7 /./<Z Total no. of SDOs monitored
Outfall No.
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No u
Parameter, (units)
Total
Rainfall,
inches
���
(
�CL
Benchmark
N/A
c
- 4
G
Date Sample
Collected,
mmlddlyy
e
-RG
S/'
2 2
7-7
z-14
24
C
SWU-264 - Generic Annual DMR
Last revised 61012018

Additional Outfall Attachment
Outfall No. )—
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No 0�'
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No L7/
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No 2
Parameter, (units)
Total
Rainfall,
inches
TJts
//
®/�
�Q�
�oL6
Benchmark
Date Sample
Collected,
mm/ddlyy
N/A
/GO
o. CF?
7e
SWU-264 - Generic Annual DMR
Last revised 61012018

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 violations."
Signature
Date ///--'7/,�_,
For questions, contact your local Regional Office:
DEMLR Regional Office Contact Information:
ASHEVILLE REGIONAL OFFICE
2090 US Highway 70
Swannanoa, NC 28778
[phone]
3800 Barrett Drive
Raleigh, NC 27609
[phone]
450 Hanes Mill Rd, Suite 300
Winston-Salem, NC 27105
[phone]
IETTEVILLE REGIONAL OFFICE MOORESVILLE REGIONAL OFFICE
225 Green Street 610 East Center Avenue/Suite 301
Systel Building Suite 714 Mooresville, NC 28115
Fayetteville, NC 28301-5043 [phone]
1433-3300
WASHINGTON REGIONAL OFFI
943 Washington Square Mall
Washington, NC 27889
[phone]
CENTRAL; OFFICE
1617 Mail Service Center
Raleigh, NC 27699-1617
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
SWU-264 - Generic Annual DMR
Last revised 6/01/2018