NCG060400_DMR_20211222

$TQ.RMSi!(J1j R DISCHARGE M0N1TCL9IN9REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Pormit No. NC6060000
Date submitted -. -12-- as _2_
CFRTIiiCAI C OF COVERAGE NO. NC606-0 4 PC) SAMPLE COLLECTION YEAR _ _q CA I
FACILITY NA_IN� � t4 �W�r•,�j"i�lY t Cl;; ._ —
COUNTY _-_�IUI �Y1__,__ - '_T SAMPLE PERIOD Jan -June July -Dec
PERSON COLLIE NG MPLES_1t7 f or Monthly4 -_ (month)
LABORATORY„ ac��__ Lab Cert. n —_, E@SCHARGING TO CLASS ❑ORW ❑HOW ❑Trout ❑PNA
•! - DEC 2 9 2021 Zero -flow ❑Water supply ❑SA
CEIS i I./,L r ILEEACIUTY ACTIVITIES INCLUDE (check all that apply):
DWRSECTION ,use/processmpats CK use animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part n 4omiw ue•r ern, 6o„arle; and Monitorini R*suits Total event rnln(all' nr No dtsehorpe tl
fluttnb lun, t` "'.' ,pl<• T35, pif, rot), tail and Grease, FOCai Conform, Entemc
/dd[yr 111 ._ Standard -units m> 1. C110111 ptar 100 ml cohinle
nrn[hnn,,; rttnnt 504
._ Within6,O 9.0 120 30 1000, - 500
_..___0 SS6 _ 31616 6121
4�0_ -oo
---------- - — -- _-
nnl; applies to facllltles that use/process meats.
'Thy t,u.al III-1111tarron must be recorded using data from an on -site roln gauge.
' f.o .,,uy,link; I tr,d: with n+a disdlatge at a� ouctalls. you nwst still submit this discharge monitoring report with a checkmark here,
t.„ n, i.,l Pt mil I.•r.t, Tabre 1, identifying the e,poc ally cen;itive roceivrne,, water daOrIcations where the murp, protective benchmark applies.
(ir+need of %omi otintwl) imv.t hrt;in with the "erond rom.,autive henchmark exceedance for the same i,aiameter at the soma outfdlt.
Did this facility perform Veitide Maintenance Activities using more than 55 gallons of now all per month? ❑ yes ;qno (H,yes complete Part B)
Permit Onto: 11/1/2018-05/31/2021 SWU-249, Last Revised 11/5/2018
Page 1 of 2

Part 0, Vehiclep Maintenance Area MonitoringResults: only for facilities averaoing a SS gal of nQw motor oil mo th.
Dato Sample Collected )4-hour rainfall amottilt, Now Matnr All ar Nori-Polar 0& /Total �c►ta�l 5uspen�ed.Soliel�
Qutta!{ No, /y) y g _ Nydr carbons
��►o/dd r Inrha� M drautlic Oil Usage Petroleum -
itejnchnta�rl�s _. _. � _... __ - _--,.. __• ..:._ .._.-. _ _ i� t1�t;% g,Al? tmRlL at SQ.tit�/t,�
_
Parameter Code 46526 NCeOIL A4.riS2 C0530
Footnotes from Part A also apply to Part B
'FOR PARU AND PAU6MONITORING RESULTS:
A i1FNCI-IMARK FX(FFI)ANCI' TRiGOFRS TiER I REQUIREMENTS. SEF PERMIT PART 11 SECTION B.
4 2 rXCLFUANCTS IN A ROW FOR THE SAM,F PARAIVI TER AT T'I-Ir SAi r OUTFAI.t TRlt GF11 TiER 2 REQUIREMENTS, SEF PERMIT PART 11 SECTION S,
fa TIER !, IAAS Ye 011 fA(:.ii.l1 Y I1AD -I OR it ORI- 1IFNc:HMARK EXCHH) lN(FS FOR 1-HE SAME PARAMFTER AT ANY ONI. OU FAI.L? YES [] NO
IF YES, IIAut; YOU c.pNTACFED THE 01-MLR REt;IONAI. OFFICE? YES ®NO
RL IONAL OFFiCF. CONTACT NAME: _T
h'TnIJ Errs ©rigFnal.copy n tft/s_ 1�1 # inc./u In _crlJ fo i?lse tffr�Pureppft& wltfil 10_cJcy .� c r Ck�,J t! nil to lrih rr_%lifts Ur_ci4_ 2< !.L �P 9.Pac!„irt h, c{Ise
of "�E� pfschr�relP".fQ��
Olvls ioll UI" wate ; Cluality
Attn: UWQ Central Files
161.7 Wil Service Center
Ll-olvigh, NC 27699.1617
f�C/ 1tl�CJ���h-UaY,`de,nnlcY of law, fillsorup�f�afta�clin.��N�ce prepared tinder my direction or sci pn
rvision in 4ar:rordance with a system
designoci to aV. :ure t1lat qe. allned per.-orenel properly gittlwr and evaivale the information Submitted. naffed on my inRuiry of, thn person or persons who
rr1.1n: l7le they systen), ov thoak- persons dire-c ly it-Vonsihle (ot go -al -wring the information, the inforimation %Libmitted is, tothe hest of my knowledge and
true►, 41(cm-ate, grid c-ampiety, l ani awk-i+t' that tllef a 4re !:Ign(ficant CAI Submitting (Allso irJot Ilia ion, inciuciing the possibility of fines and
in-rpri+o meet for knowing violations."
l
Signature of Permittee Date
P rtnit SWU•249, 0st Revised 11/5/2018
Page 2 of 2