NCG060400_DMR_20201221

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000
Date submitted / _� -,2 /- ,2---
CERTIFICATE OF COVERAGE NO. NCG06 C L/ C SAMPLE COLLECTION YEAR O i
FACILITY NAME Cc.-,,- SAMPLE PERIOD ❑ Jan -June July -Dec
COUNTY G I or ❑ Monthly' (month)
PERSON COLLECTING SAMPLES 1 �7 Ll�
LABORATORY• Wi A,w-�_F .. / Lab Cert.It Ufa 1 DISCHARGING TO CLASS ❑ORW ❑HQW -]Trout ❑PNA
�— ❑Zero -flow ❑Water Supply ❑SA
©Other r r D
RECEIVE
JAN 11 2021
Ccta I i ^,L Fllc ;
D.t A. ca....,...nter Rcnrhmnr4< end Mnnitnrinp Rpsults
FACILITY ACTIVITIES INCLUDE (check all that apply):
QC use/process meats Muse animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall' or ❑ No discharge this period'
. a...-.. .............._
Outfall No.
.............._..._ _.._
Date Sample
Collected, mo/dd/yr
.-._...-_..._o
TSS,
mg/L
PH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform,
Colonies per 100 ml
Enterococci,
Colonies per 100 ml
Benchmark
-
l000r50'
Within 6.0 - 9.0
120
30
10001
500,
Parameter Code
-
C0530
00400
00340
00556
31616
61211
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalis. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
'Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? ❑ yes no (if yes• complete Part B)

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Date Sample Collected
(mo/dd/yr)
24-hour rainfall amount,
Inchee
New Motor Oil or
Hydraulic Oil Usage
Non -Polar O&G/Tota!
Petroleum Hydrocarbons
Total Suspended Solids
Benchmarks
-
-
-
15 mg/L
100 mg/L or 50 mg/L4
Parameter Code
-
46529
NCOIL
00552
COS30
Footnotes from Part A also apply to Part B
*FOR PART A AND PART B MONITORING RESULTS:
•0 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 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this OW includina all "No Discharge" reporM within 30 days of receipt of the lob 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
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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 penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations."
/Z 0 / 0)_ -
Signature of Permittee Date