NCG210410_DMR_20210112

CERTIFICATE OF COVERAGE NO.
FACILITY NAME __. 41 Yc_�
COUNTY % rre ri
PERSON COLLECTING SAMPLES
Comments on sample
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina DEMLR General Permit No. NCG210000
Datesubmitted //I Z I/oZC)7-
10
Lab Cert. q
or analysis:
SAMPLE COLLECTION YEAR &�yL9, 0
SAMPLE PERIOD ❑ Jan -June July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA
❑Zero -flow ❑Water Sup I [:]SA
JAN 2 2021
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results (Monitoring is required only if the facility stores exposed accumulations of sawdust, wood chips,
bark, mulch, or other similar material on site for longer than seven (7) days.)
9 No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Chemical Oxygen Demand
Total Suspended Solids
Benchmarks
120 mg/L
1oo mg/L or 50 mg/L
Alt) Sc lrl
Ai d,
f
49
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance 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.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
' See General Permit text, Table 3, 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. "<XX me/L'. where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L.
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: 8/1/2013-7/31/2018 SWU-245, last revised 7/31/2013
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Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
P No discharge this period:
Outfail No.
Date Sample
Collected`
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
Benchmarks =-->
_
-
15 mg/L
100 mg/L or 50 mg/L`
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, Tier 2, or Tier 3 responses. see General Permit text.
FOR PART AAND 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 ANYONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, includinq all "No Discharqe" reports, within 30 days of receipt of the lab results for at end of monitorina Period
in the case of "No Discharge" reoortsJ 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 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 sign if4nenaltiesfor submitting false information, in the possibility of fines and imprisonment for knowing violations."
(S' ureo rmitteel (D t l
Permit Date. /1/2013-7/31/2018 SWU-245, last revised 7/31/2013
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