NCG030436_DMR_20201130 (2)

5tormwater Discharge Monitoring Repo.rt
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG030000
Date submitted C/� all�Cl
CERTIFICATE OF COVERAGE No. NC 03 iJ �. SAMPLE. COLLECTION YEAR_^____�
FAGILITy.NAME SAMPLE PERIOD ❑Jan -June ❑July -Dec
COUNTY GFt�/ED or [9%gonthly1 r (month)
PERSO:N.COLLECTINGSAMPLES RERE DISCHARGING TO CLASS [-]ORW ❑HQW QTrout ❑PNA
Comments on.
'Td
Lab Cert. ff DEC 14 NZ0 Qv Zero -flow QWater Supply []SA
sis: _ .___ _. .,Cc []Other
Part. A: Stormw.ater Benchmarks and Monitoring Results
PLEASE REMEMBER TO.SIGN ON PAGES 2 AND/OR 3
0�- 'No discharge this period??
Outfall No.
Date.Sample
Collected'
(mo/dd/yr)
24-
ou.r.ratnfall
mount,
nches3
Total suspended Solids
pH,
Standard units
Total Copper
Total Lead
Total Zinc
Non-Polar O&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics
Benchmarks'
160 mg/L or So mg/V
6.D-9.0
0,010 mg/L
0.075 mg/L
0.126 tng/L
15 mg/L
1 mg/L
Parameter Code
-
46529
C05.30
0040.0
01119
01051
01054
00S52
78141
}.Monthly sampling (instead of semi-
2 For sampling periods with no discha
3The total precipitation must be rec(
',See General permit, :Section B,Tabl
5 Total Toxic Organicssarripiingis apl
electronic crystals, or. manufacture c
Effluent -Guidelines forth'e facility.su
manufacture use the definition as fo
tube. manufacture use:the definition
ival) must begin with the second consecutive benchmark exceedance:for,the same parameter at the same outfall.
!.at. any single outfall, you.must still submit this discharge monitoring report with a checkmark here.
:d using data from an on, site rain gauge. Unattendedsites:may be eligible for a waiver:of the rain gauge requirement.
to'id.entify the especially sensltive receiving water classifications where'the more protective. benchmark -applies.
able only for those. facilities. which perform metal finishing operations, manufacture semiconductors, manufacture
ode ray tubes. For purposes oftW permit the definition.of Total Toxic Organics,is that definition contained in:the'EPA
A to the requirementto sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
I in 40 CFR 469.12; for ele.ctronic,erystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
ind in 40 CFR 469.31).
Permit Date:11/1/2018-05/31/2021
SW.U-245, last revised 11/1/2018
Page 1 of3

Facilities- that incorporate a solvent management plan into -the Storniwater Pollution Prevention Plan* may so certify; and the.requirernent.for T-T.O monitoring
may be waived. The. solvent.marnage ent plan -shall include a list of the total toxic organic -compounds used and the-otherelernents listed in the General
Permit. For those facilities electing .to employ. -the.TTC) monitoring waiver, the discharger -shall -sign the following certification statement:
"Based. -upon* my inquiry of the person or persons directly responsible fdr-managi'ng compliance with the permit'nionitoring requirement for total. .toxic organics
(TTO), I certify that the best o my knowledge and belief, no dumping -of concentrated toxic orgariics-into the stormwater or areas which are'exposed to rainfall or
stormwater.runoff has'o.ccurred. sihce filing.th-e last discharge ionitoring r-epoit. I further certify -that this facility is implementing the all the.provisions of the
solvent management plan iridud d%in the'Storrriirvater. Pollution Prevention Plan."
a- 116-
Name (Pfl t name)
I'L 0 ta &- nl�� '<il-
Titie (Print title)
Signature. Dace
Note,: Results must be -reported in numerical format. Do not report Below Detection-L'irnit, BDL, <PQL,.Non-detect, ND, orbthersiMilar non -numerical
format: When results are below the z pplicable limits,. they must -be reported in*tbe format, "<XX mg/L",..vi,he.re XX is the numerical value -of the detection
limit, reporting limit, -etc. in rrig/L.
Note: !f,you report: a.satnple value io excess of -the benchmark. you must-lmplement.Tier 3. Tier. 2,- or Tier. 3 responses. See .Genera! Permit text.
Part B:'-Vehicle Maintenance Are - Monitoring Results: only for facilities averaging >:55.ga1 of new oil per -Month.
n No- discharae=thi.sberiod?z
Outfail'No.
Date S
ample Collected)
my/dd/y.r)
24-hour rainfall amount;
Inches
New Mvtor. Oil or
Hydraulic.0il Usage
Non -Polar Q&G/ Total
Petroleum Hydrocarbons
Total5uspended
Solids
Benchmarks
-
-
15 mg/L
100 mg/L or 50 mg/O
Paratheter Code
-
4652!
-NCOIL
00552
CO530
Footnotes from Part A also:apply to Part B
Note: If you report o.sample value i .excess of the benchmark; you; n'ustimplement*Vi r-1, Tler2, or- Tier 3 responses: See Gerferal Perinit,text.
Permit Date: 11/1/Z2Q .05/3 /2021 5V1lU-245, last revised:11/1/2018
Page 2.of-3

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