NCG060102_DMR_20210706

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. i dCG06000i
Date submitted -CLLI V r0 01-011 L
CERTIFICATE OF COVERAGE N�QQ. NCG06 O_1 0 SAMPLE COLLECTION YEAR a() at
FACILITY NAME C0.ndDr �xRdrrull - I�v�Lt2. g-rt StAsirtesps �L-LC FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY MDor� NLCElVEDase/process meats Ouse animalfas/byproducts
PERSON COLLECTING SAMPLES JULpISCH RGING TO SALTWATERS? ❑YES O
LABORATORY Lab Cert. # �i 2021
EN I F2AL FILES PLEASE REMEMBER TG `_ s ON THE REVERSE
DWR SECTION
Part A: Stormwater Benchmarks and Monitoring Results Tntnl avant rninfn/l ' nr fi/t, , arr ti e «A;, . ;-A3
Outfall No.
Benchmark
Sample Collected,
mo/dd/yr
TSS,
mg/L
100 or 504
pH,
Standard units
Within 6.0-9.0
COD,
mg/L
120
Oil and Grease,
mg/L
30
Fecal Coliform ,
Colonies per 100 ml
1000
Enterococci ,
Colonies per 100 ml
Soo
Only applies to facilities that use/process meats.
ZThe 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 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Qryes ❑ no (if ves. complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > ss pal of naw mntnr nil/mnnth
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS, V V
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average,gal/mo
Benchmark
-
30
100or50
6.0-9.0
-
Only applies to facilities that use/process meats.
ZThe 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 3, identifying the especially sensitive receiving water classifications where the more protective benchmaI dies.
SWU-249 Last Revised: October 18, 2012

*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 Ee
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR including all "No Discharge" 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 penaltiesfor submitting false
information, including the possibility of fines and imprisonment for knowing violations."
-•f
aoa
(Signature of Permittee) (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wa/ws/su/npdessw#tab-4
SWU-249 Last Revised: Oc r 18, 2012 '
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