NCG060400_DMR_20221215

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000
Date submitted / I ' 5 a A
CERTIFICATE OF COVERAGE NO. N00060L1 Q l7
FACILITY NAME Sin �,y<����r�icG� CbM?��/
COUNTY
PERSON COLLECTING SAMPLES l5ren�D/ �`rJuvfC'_
LABORATORY 1P`c7,c,_-A/)Nj yrF;c,o,l Lab Cert. # H 6 6
RECEIVED
ou 2 0 2022
GEM KAL Ir1LEI:�:
DWR SECTION:
Part A- Stormwater Benchmarks and Monitorine Results
SAMPLE COLLECTION YEAR V
SAMPLE PERIOD ❑ Ian -June N July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow [:]Watersupply ❑SA
QOther 5iwr-`1 INo'vic / 0 Jf*1')J 4
FACILITY ACTIVITIES INCLUDE (check all that apply):
1Z use/process meats ❑ use animal fats/byproducts
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall' or ❑ No discharge this period'
Outfall No.
Date Sample
Collected, mo/dd/yr
T5S, V
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform,
Colonies per 100 ml
Enterococci,
Colonies per 100 ml
Benchmark
100 or 50'
Within 6.0 — 9.0
120
30
1000' —
S001
Parameter Code
-
C0530
00400
00340
00556
31616
61211
' 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 outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Did this facility perform Vehicle Maintenance Activities using more than SS gallons of new oil per month? ❑ yes ® no (if yes, complete Part B)

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
OutiFall No.
Sample Collected
(mo/dd/yr)
24-hour rainfall amount,
Inchesz
New Motor Oil or
Hydraulic Oil Usage
Mon -Polar O&G/Total
Petroleum Hydrocarbons
Total Suspended Solids
Benchmarks
-
-
-
15 mg/L
100 mg/Lor 50 mgfL4
Parameter Code
-
46529
NCOIL
00552
C0530
.Jl_((f •.
Footnotes from Part A also apply to Part B
*FOR PART A AND PART B MONITORING RESULTS:
o A BENCHMARK EXCEEDANCE TRIGGERS TIER g 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 :TAME PARAMETER AT ANY ONE OUTFALL? YES [:] NO
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ No
REGIONAL OFFICE CONTACT NAME:
Gif!®il an ornwinal copy off this DIM including all "No Dischraraef reports, within 30 days of receipt of the tab results for at eyed of monitoring period in the case
of "No Discharge"repoaW to:
Division of Water Quality
Attn: DWQ Central Files
1617 frail Service Center
Raleigh, NC 27699-1617
YOU DUST SIGN THM CERF§F'lCAT00N FOR A6tilYMUFOlBMAT10N 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, rue, accurate, and complete. I am aware that there are significant penalties for sub mitti ng.fa Ise information, including the possibility of fines and
inrprisbnment 4r knowing violations."
Vgnature of
Date