NCG080715_DMR_20210107

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STORM EVENT CHARACTERISTICS:
Date (first event sampled)
Total Event Precipitation (inches):
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: if you report a sample value in excess of the benchmailk, you must implement Tier 1, Fier 2, or Tier 3 responses. See General permit text.
FOR PART A AND PART B MONITORING RESULTS:
o 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.
m TIER 3: HAS YOUR FACILITY HAD z OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAME" ER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an orWinai and one copy of this DMR, including all "No Discharge" resorts, within 30 dabs of receipt of the lab results for at end of monitoring period in
the case of "No Dischara. e" reports) to:
Division of Water Quality
Attn: DWQ Cent -al Files
1617 Mail Service Center
Raleigh, North Carolina 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 responsibl 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 sigpificantenalties fX submitt�g false information, including the possibility of fines and imprisonment for knowing violations."
(Date)
onal copies of this form may be downloaded at: http:/Jportal.ncdenr.org/web/wg/ws/su/np-dessw#tab-4
SWU-250 last revised October 25, 2012
D.,..o 7 -F 7

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NCD►ENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: http://12ortal.ncdenr.org/web/wq/�,/� f�pdessw#tab-4
Permit No.: N/C/�r/D-/ /-0/O/0 Oy or Certificate of Coverage No.:
Facility Name: _CfL
County: 0 Phone No. Y10 `,Y6 -.). - 6000
Inspector: ,10 � v.-j
Date of Inspection: v U
Time of Inspection: Rio: cU Apli
Total Event Precipitation (inches): e7
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See inforZr
low.)
❑ Yes
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event" or during a "measureable storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By thi�na�ur ,ff
cer ,fat this report is accurate and complete to the best of my knowledge:
oT Permittee of Designee)
Pagel of 2
SWU-242, Last modified 10/25/2012

1. Outfall Description:
Outfall No. / Structure (pipe, ditch, etc.) _
Receiving Stream:�1
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge
(light, medium, dark) as descriptors: A
basic colors (redbz4wn, blue, etc.) and tint
3. Odor: DesrrihP any distinct odors that the discharge
weak chlorine odor, etc.): AY-1
have (y�lsmells strongly of oil,
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy, �,
�} 1 2 3 4 5
5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1' 2 3 4 5
b. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes 0
9. is L11ere evidence of erosion or deposition at the outfall? Yes 10
10. Other Obvious Indicators of Stormwater Pollution:
List and describe P d
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/2S/2012