NCG030436_DMR_20201211 (2)

Stormwater Discharge Monitoring Report
for North Carolina Division .of Energy,. Mineral and Land Resources General Permit Na. NCGO30000
Date submitted 1A II//A0.20
CERTIFICATE OF -COVERAGE NO. NCG03-a L� SAMPLE. COLLECTION YEAR oAQAQ
FACILITY. NAME t];�c - SAMPLE PERIOD ❑ Jan -June: Q July -Dec
COUNTY jj arC or ❑_'MonthIV (month),
PERSON.COLi.ECTINGSAMPLES 4pnuA IA%��I� DISCHARGING TOCLASS ❑ORw ❑HQw []Trout❑PNA
LABORATORY. ptj(+ rb Cert# ❑Zero flaw ❑Water Supply ❑SA
Comments on.samplecollectionoranalysis: . I�ECf/1 [2Other C�A/Se._�
nrmr.ra� r��tr�n;_CnI1FrF�cL .gin Nnil.
r �u2 j 2820 PLEASE REMEMBERTO.SIGN ON PAGES 2.AND/OR 3'
Part A: Stormwater Benchmarks arid Monitoring Results DiM L FILE.
ECT(ONI ❑ No dischar a this er' d p2
Outlall No.
Date.Sample
Collected_
'
(mo/dd/yr)
24-hour.rainfall
amount
Inches'
Total Suspended Solids
H
p '
Standard units
Total Copper
Total lead
g .
Total Zinc
p. . .
Ndti-PolarO&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics
Benchmarks
_
-
100 mg/I. or SD mg/0
5.D-9.0
0.010 mg/L
0.075 mg/L
0.226 mg/L
15 mg/L
1 mg/L
Parameter code
-
46529
C0530
00400
0>119
01651
01094
005S2
78141
(a
in.ly
• .,,,r Jmueuug %I,I:kIC.QU U, =1I 11-dbbudu muse begin with the second consecutive Denchmark exceedance:forthesbme parameter atthe 'same.4utfall:
Z For sampling periods with no discharge at any single outfall, you.must still submit this discharge monitoring report with a checkmarkhere.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended' sites: may be eligible for a waiver:of therain gauge requirement:
° See General Permit, Section B, Table 1 to identify the especially sensitive receiving water classifications where the more protective_ benchma.rk tipplies.
s Total Toxic Organics sampling'is applicable only for those facilities. which perform metal finishing.operations, manufacture semiconductors, niinufacture
electronic crystals,_or manufacture cathode ray tubes. For purposes of this permit the definition.of Total Toxic Organics,is that definition contained .in,the'EPA
Effluent GulBelines for the facili y.subject to the requirementto sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 4'0 (FR 469.12; forelectronit crystal manufacture use the'definition as found in 40 CFR 469.22;.an4for cathode ray
tube. manufacture use the definition found in 40 CFR 469.31).
Permit Date:11/1/2018-05/31/2021 SW.0 745, last revised 11/1/2018
Page 1 of3

Facilities that incorporate a solvent. management plan into the Stormwater Pollution Prevention Plan may so certify; and the. requirement.#or T70 monitoring
may be waived. The solvent. management plan shall include a list of the total toxic organic compounds used and the other -elements listed in the General
Permit. For those facilities electing to employ the TTQ monitoring waiver, the discharger shall sign the fopowi.ng certification statement:
"Based upon my inquiry of the person or persons directly responsible formanaging compliance with the:permitrrianitoring requirement fortotal tgxicorganics
"(TTO), I certify that .to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are'expo;ed to rainfall or
stormwaterrunoffpas occurred.shice filing. the last discharge ffonitoring report. 1 furthercertify that this facility is implementing .theall the provisions of the
solvent management plan included.in theStormWater Pollution Prevention Plan."
Sg;l wal 5 h
Name (Pr) ame) -
w -I�Uir AMF AI �1,1 ��a 5A ' i t� r-.
Title (Print title) J
Signature. 0 Date
Note.: Results must be reported in numerical format. Do not report Below Detection Umit, BDL, <PQL,. Non -detect, ND, or othersimilar 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 reporea sorrrple value hi excess of the benchmark, you mustimplement.Tier 1, Tier 2, or Tier. 3 responses. See tseneral Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging >.SS.gal of new oil perhionth.
Outfall No.
Date Saimple Collected'
(mo/dd/yr)
24-hour rainfall amount;
Inches;
New Motor Oil or
Hydraulic Oil Usage
Non -Polar Q&G/Total
Petroleum Hydrocarbons
Tota[Suspended
Solids
Benchmarks
-
-
15 mg/L
100 mg/L or 50 mg/0
Parameter Code
-
46529
NCOIL
00552
C0530
Footnotes from Part A also apply to Part B
Note: if you report a somple value in. excess of the benchmark, you: must implement Tier 1, tier2, orTier 3 responses: See General permit text:
Permit Date.,11/1/201&OS/31/2021 SNtU-245, last revised'1'/1/20I8
.Page 2.pf 3

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