NCG060235 - Domino's Pizza Distribution

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted
CERTIFICATE OF,cOVERAGE NO. NCG060 a.2 5 SAMPLE COLLECTION YEAR L (S
FACILITY NAME Pp v ∎i U e‘S?c Z Z-R— L C FACILITY ACTIVITIES INCLUDE(check all that apply):
COUNTY i.'oc n use/process meats n use animal fats/byproducts
PERSON COLLECTING SAMPL S 2 l L 1�\_- DISCHARGING TO SALTWATERS? OYES Qico
LABORATORY 12f. AN Ci� keit I Lab Cert. # to "7
Y PLEASE REMEMBER TO SIGN ON THE REVERSE -3
Part A:Stormwater Benchmarks and Monitoring Results Total event rainfall2 or [ I No discharge this period3
Outfall No. Sample Collected, TSS, pH, COD, Oil and Grease, Fecal Coliforml, Enterococcii,
mo/dd/yr mg/L Standard units mg/L mg/L Colonies per 100 ml Colonies per 100 ml
Benchmark - 100 or 504 Within 6.0-9.0 120 30 1000 500
1 -.), 13, 1$" ?a jog 2r,(;)f tiI
1 Only applies to facilities that use/process meats.
2The 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.
4See General Permit text,Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? U 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.
Outfall No. Sample Collected, Oil and Grease, TSS, pH, New Motor Oil Usage,
mo/dd/yr mg/L mg/L Standard units Annual average gal/mo
Benchmark - 30 100 or 504 6.0-9.0 -
1 Only applies to facilities that use/process meats.
'The 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.
4See General Permit text,Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SWU-249 Last Revised: October 18,2012
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