NCG060364_DMR_20211018

for North Carolina
CERTIFICATE OF COVI
FACILITY NAME Br
COUNTY P; t i'
PERSON COLLECTING
of Energy, Mineral and Land Resources General Permit No. NCG060000
Date submitted / Cp Oct ZOL
i! FP/ri/ni II
)RY EnI42 /2 261 04/M/J*ab Ce #
RECEIVED
OCT 22 2021 CAVED
CENTRAL FILES ( 2021
DWR SECTION EN'TRAL FILES
lWR SECTION
Part A: Stormwater Benchmarks and Monitoring
SAMPLE COLLECTION YEAR Z A Z /
SAMPLE PERIOD ❑ Jan -June 211uly-Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HCtW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply []SA
®Other A ie /i
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall 2 4 r' or ❑ No discharge this period'
Outlall No.
Date Sample
Collected, mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Collform,
C onies per 100 ml
Enterococci,
Colonies per 100 ml
Benchmark
-
100 or 50'
Within 6.0-9.0
120
30
10001
Sao'
Parameter Cade
-
C0530
1 00400
00340
00556
31616
61211
a
0 1 a
-T.L
6.9
<so
1 Only applies to facilities that use/process meats.
'The total precipitation must be recorded using data fro i an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. u must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 1, identifying the especia sensitive receiving water classifications where the more protective benchmark applies.
y
'Monthly sampling (instead of semi-annual) must begin h the second consecutive benchmark exceedance for the same parameter at the same outfall.
Did this facility perform Vehicle Maintenance Acti ties using more than 55 gallons of new oil per month? ❑ yes 9no (if yes, complete Part B)
Permit Date: 11/1/2018-05/31/2021 SWU-249, Last Revised 11/5/2018
Page 1 of 2

i
Part B•
Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
.
New Motor Oil or Non -Polar O&G/Total
Outfall No. Date Sample Collected 24-hour rainfall amount, Total Suspended Solids
(mo/dd/yr) Inchee Hydraulic Oil Usage Petroleum Hydrocarbons
Benchmarks - - - 15 mg/L 100 mg/L or 50 mg/L°
Parameter Code - 46529 NCOIL 00552 C0530
Footnotes from Part A also apply to Part B
*FOR PART A AND 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 ANY ONE OUTFALL? YES ❑ NO Er
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR, including all "No Discharae" reports, within 30 days of receipt of the lab results for at end of monitorina 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
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."
Signature of Permittee
Permit Date:11/1/2018-05/31/2021
Date
aefZ'�Z)
SWU-249, Last Revised 11/5/2018
Page 2 of 2
Footnotes from Part A also apply to Part B
*FOR PART A AND 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 ANY ONE OUTFALL? YES ❑ NO Er
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR, including all "No Discharae" reports, within 30 days of receipt of the lab results for at end of monitorina 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
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."
Signature of Permittee
Permit Date:11/1/2018-05/31/2021
Date
aefZ'�Z)
SWU-249, Last Revised 11/5/2018
Page 2 of 2