NCG030436_DMR_20210802

for North Carolina Division .of I
�j/nergy, Mineral and Land Resources General Permit No, NCG030000
Date -submitted 2 I P.-C)2i
CERTIFICATE OF
FACILITY. NAME
COUNTY L1 )
PERSON COLLEC
iE NO. NCG03
PLES
Lab Cert. #
on sample collection or analysis:
Part A: 5tormwater Benchmarks and
Rif ED
AUG 0 8 Z971
CENTRAL
S CTON
SAMPLE. COLLECTION YEAR
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or DIVlonthly' T u inohth
DISCHARGING TO CLASS EIORW ❑FI W "Trout ❑PNA
Zero -flow "Water smpply "SA
❑Other
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3'
Outfall No.
Date.Sample
Collected ,
(mo/dd/yr)
24-hou.r.(ainfall
amount,
Inches;
Tot
Suspended Solids
P H,
Standard units
Total Copper
TotahLead
Total Zinc
Non -Polar O&G
Total Petroleum
Hydrocarbons
Total Toxic
Organicsz
Benchinarks
_
-
160
mg/L or 50 mg/0
6.0-9.0
0.010 nag/L
0.075 mg/L
0.126 mg/L
15 mg/L
1 mg/L
Parameter Code
-
46529
C0530
00400
01119
01051
01094
00552
78141
- 1-001 my wulfiung imbtuou ul Seim-annuatf muss Degit
For sampling periods with no discharge_at. any single o
'The total precipitation must be recorded using data fri
See General Permit, Section B, Table 1 to identify the i
s Total Toxic Organics samplingis applicable only for thi
electronic crystals, or manufacture.cathode ray tubes.
Effluent Guidelines forthe facility. su bject to the require
manufacture use the definition as found in 40 CFR'469.
tube manufacture use the definition found in 40 CFR 4E
to the second consecutive benchmark exceedance _for.the same parameter at the same. outfall.
ill, you -must still subrriftthis discharge monitoring' report with a ch'eckmark.here.
an on -site rain gauge. Unattended sites: may be -eligible for a waiver:of the rain gauge requirement.
ecially sensitive receiving water classifications where the more protective benchmark applies.
facilities. which perform metal finishingoperations, manufacture semiconductors, manufacture
purposes of this permit the definitfon.ofTotal Toxic Organics is that definition contained ln.the EPA
:nttasample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
for electronjccrystal manufacture use the'deflnftion as found in 40 CFR 469.22; and for cathode ray
Permit Date:11/1/201$-05/31/2021
SWU.245, last revised 11/1/2018
Page 1 of 3

Facilities that incorporate a solvent management plan into the Stbrmwater Pollution Prevention Plan- may so certify, and therequirement for TT.O monitoring
may be waived. The -solvent management plan shall in Jude a list of the to.kal toxic organic -compounds used and tite'other`elemsnts listed in the General
Permit. For those facilities electing .to employ. •the.TTO onitoring waiver, the dischatger`shall sign the following certification statement:
'%ased-upoh my inquiry of the person or per$ons dii ectly responsible for -managing compliance with the:permit�rrion(torhig requirement for total .toxic organics
(TTO), 1 ceitlfy that.to the best of my'knowledge ari belief, no dumping -of concentrated toxic orgahics-i-rito the stormwater or areas which are exposed to rainfall or
stormwater.runoff has`9ccurred.sihce filing.the last fischarge iftnitoring sport. I further certify -that this -facility im-all theons.of the*
solvent management plan included in the 5torrhWa r- Pollution Prevention Plan."
Name (
Title (Pt(int title).
��• 1 I
Note: Results must be -reported in numerical format.
format: When results are below.the applicable limits,•
limit, reporting limit, etc. in mg/L.
Note: If you reportssarrlple value M excess of the
Part B: , Vehicle Maintenance Area Mon.itor-ing
ea
0 !ln'� .(
Date
Sort Below Detection Limit, 9DL, <PQL,. Non -detect, ND, or-other.sirnilair non -numerical
'be reported In 'the- format.,"<XX mall _.Where XX is the numerical value of the detetti.on.
ark, you mustimplement. Tier 3, Tier. 2, -or Tier. 3 responses. See General Permit text.
ults:-only for facilities averaging > 55.gal of new oil -per -Month.
^
1 I Ain riicrhrlrnv thic'nvrinrl?Z
Outfall'No:
Date Sample Coildded.1
(mo/dd/-yr)
24-hour rainfall amount;
Inchesg
New Motor. Oil or,
Hydraullc Oil Usage
Nan -Polar O&G/ Total
Petroleum Hydrotarbong
Total Suspended
Solids
Benchmarks
-
-
15 mg/L
200 mg/L or 50 mg/O
Parameter Code
-
46529
NCOIL
00552
C0530
Footnotes from Part A also:apply to Part B
Note: If .you report a.sample value in.excess of the ben hi mark; you: n`u0implement'Tier'l, 71er2, or -Tier 3 responses:
Permft Date: 11/1/20.18&:05/31/2021
See General Permit- text:
5WU-24S, last revised:11/1/2018
.Page 2.of-3

I= R PART A AND PART 13 MONITORIN RESULTS?
o A BENCH MARK'EXCEEDANCE TRIGGERS TIER 1 RECK 1IREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEUANCES IN A ROW FOR -THE.'
ER ATTHE SAME.OUTFALL TRI'GGER'TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
TIER*$: HAS YOUA FACILITY HAD 4, OR MORE BENCI IMARK EXCEEDENC S FOR T�iE SAME PARAMETER.ATANY O.NE'OU7EgLL? YES
I NO❑
IF YES, HAVE YOU.C,ONTACMD THE DWQ REGIONAL OFFICE? YES QZNO []
REGIONAL OFFICE CONTACT NAME: 1 , ' r '
an
is
case of "No Discharge" reports) ,to:
Division -of Water Quality
Attn: OWQ Central Files.
1617 Mail Service Center
Raleigh, North Carolina 27.69.9-1617
Wo Discharge."
J
"I certify, under penalty -of -law..,--that this document and all attpchments were prepared .under -my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the,inform.ation submitted. Based on my inquiry of the person or persoris who manage the system,.or
those persons directly responsible for gathering,the: informat on, th'e information submitted is, to -the best of my knowledge and belief, :true, accurate, and comp.lete:. I
am aware that -there are significant penalties -for submitting f lse information; including the pos'sibilitj -of fines abd imprisonment for.*knowing violations."
Signature of'.Perrrii tee.
Date
Permit Date: it/1/2018-05/31/2021
.$0-245, lastreriised'11/1/20i8&
Page 3 of'3