NCG120087_DMR_20201105

RECEIVED
JAN 04 2021
CENT K/tL FILES
DWR SECTION
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and land Resources General Permit No. NCG120000
Date submitted Hoverter 5, M0
CERTIFICATE OF COVERAGE No. NCG12 0 0 8 7 SAMPLE COLLECTION YEAR 2020
FACILITY NAME mviix h Cwnly l 11 SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
pa COUNTY dohnpcn or (] Monthly` October Imonthl
PERSON COLLECTING SAMPLES tame 13. ueei (S-G) DISCHARGING TO CLASS ❑ORW ❑HQW [-]Trout ❑PNA
LABORATORY Pace Analytical Lab Certp 37738 []Zero -flow [:]WaterSupply [:]SA
Comments on sample collection or analysis: ]10therc. NSW
� No samCleade Elxharge.
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
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Part A: Stormwater Benchmarks and Monitoring Results
No discharge this period=
OuthO No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Chemical Oxygen
Demand
mg/L
Fecal Colifarm
Ca
Colonies per 100 mL
Total Suspended
Solids
mg/L
pH,
Standard Units
Benchmarks
_
-
no
1000
IDO or soh
6.0-9.0
Pammeter Code
-
46529
00340
31616
C0530
00400
SDO-A
No Discharge
No Discharge
No Discharge
No Discharge
No Discharge
No Discharge
SD04A-SA
Na Discharge
No Dluharge
No Discharge
No Discharge
No Dlxharge
No Discharge
SDO-8
No Discharge
No Discharge
No Discharge
No Discharge
No Discharge
No Discharge
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceeciance for the same parameter at the same outfall.
For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
37he total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible fora waiver of the rain gauge requirement.
4 See General Permit text, Table 1, Identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example. do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format. "<= me/L". where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal collform results exceed the dilution upper limit, report the result as ">XX"
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2018-5/31/2021 SWLL248, last revised 11/1/2018
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averagiri SS gal of new oil per month.
n No discharae this period'
Outfall No.
Date Sample Collected'
Imo/dd/yr)
24-hour rainfall amount,
Inches
Non -Polar 00 g Grease
mg/L
Total Suspended Solids,
M91L
New Motor or Hydraulic Oil Usage,
gal/Mon
Benchmarks
_
-
15
100 or SW
Parameter Code
-
46529
005s2
C0530
NC(ML
SDO-A
No Discharge
No DWorge
No Discharge
No Discharge
No Discharge
Footnotes from Part A also apply to this Part B
Note: if you report a sample value in excess of the benchmark, you must Implement Tier 1, Tler 2, or Tier 3 responses. See General Permit text.
A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION S.
• 2EXCEEDANCES INA ROW FOR THE SAME PARAMETER AT THE SAME OUTFALLTRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES QNO❑
IF YES, HAVE YOU CONTACTED THE DEMUR REGIONAL OFFICE? YFS ❑' NO ❑
REGIONAL OFFICE CONTACT NAME: mmv,h -
Mail an ariainal copyof this DMR. Including all "No Discharge" reports. within 30 days of receipt of the lob results for at end of monitorma period in the
rose of No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central 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 responsible forgathering 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."
l //. 4�. ' A"
Sign ennfttee Date
Permit Date: 11/1/2019-5/31/2021 SWU-248, last revised 11/1/2018
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