NCG060335_DMR_20220628

� S E — J�J\\ �lull ANNEAL ST®RIQ/01dVATER DISCI ARGE MONITORING REPORT 1 )
for North Carolina Division of Water Quality General Permit NO. NCGD60000
Date submitted�- Z — � �
CERTIFICATE OF CO
V RAGE NO. NCG®6o,�,3�'
FACILITY NAME -es �M SAMPLE COLLECTION YEAR :20d,;21
FACILITY ACTIVITIES INCLUDE(check all that apply):
'1f1�
COUNTY -Seel
PERSON COLLECTING SAMPLES S'i's►�
�� Q� use/process meats use animal fats/byprodu� ���. ,��';,�-��
C DISCHARGING TO SALTWATERS? []YES O
LABORATORY �n„r�„,,,,,s�( G,t e c�,y ❑t� b°"��-lC��
b Ce� . $d
PLEASE REMEMBER TO SIGN ON THE REVERSE 4Part A:Stormwater Benchmarks and Monitoring Results
Total event rainfall Z °r ❑7 S
No discharge this period''
n
-Y 1j7.
of �•'�a 6` y �.. �r g Qa �a. $ s e y Y l :, i
5S•D S C�
Only applies to facilities that use/process meats.
ZThe 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.
QSee General Permit text,Table 3,identifying the especially sensitive receiving water classifications where the more protective be
nchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?
Part B:Vehicle Maintenance Area Monitoring �yes
�nO (if es complete Part B)
Results:only for facilities averaging>55 gal of new motor Oil/month.
`Zvi
EC ENED
Only applies to facilities that use/process meats. 2022
ZThe total precipitation must be recorded using data from an on-site rain gauge. SAL RLES
3 rote For sampling periods with no discharge at outfalis,you must still submit this discharge monitoring report with a check
mark
any General Permit text,Table 3, identifying the especially sensitive receiving water classifications where the more mark here.
protective benchmark applies.
S WU-249
Last Revised: October 18,2012
PAun. 1 of 7 ,

f
' FOR P� J )
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 OUTFACE TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B,
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SA
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES []NO[�
ME PARAMETER AT ANYONE OUTFACE? YES []NO
REGIONAL OFFICE CONTACT NAME:
Mail an orl ina/and one co 11110 this DMR includin all"No Dischar e"reports wit
monitorin erlod in-the case o "No Discharae"reports)to:
within 30 da s o recei t of the lab results or at end o
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOu MflsT sIGN Tllls CERTIFICATION FOR ANY/NFORAiM
"I certify, under penalty of la w TIOIV REPORTED:
,that this docurnent and alf attachments were re
System designed to assure that qualified personnel properly prepared under my direction or supervision in accordance with a
person or persons who manage the system, or those persons directly responsible for gathering y gather and evaluate the information submitted. Based on my inquiry of the
to the best of my knowledge and belief, true, accurate;and complete. I am aware that information, including the possibility of fines and imprisonment f g Bring the information,the information submitted is,
at there are significant penalties for submitting false
or(crowing violations."
(Si a of Permittee) �_ Z
(Date)
Additional copies of this form may be downloaded at: htt
ortal.ncdenr.or web w ws su n dessw#tab-4
s
S WU-249
Last Revised; October 18,2012
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