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See General Permit text. 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 n IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES NO❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all"No Discharge"reports, within 30 days of receipt of the lab results(or at end of monitoring period in the case of"No Discharge"reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 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 ere are sign' 'cant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." 41 1 !S (Signature of Permittee) (Date) Permit Date: 11/1/2012-10/31/2017 I SWU-248, last revised 10/25/2012 Page 2 of 2 0 c ° O 3 1 e ' ¢: o rn > z 4 it o p O G 0 D J C. AD cD ;-.1 d a w. ) O ¢" cD • Cr Q 0 N co W G C p n vC z _ 0 CD X O c p �. O n A O ilD `0 �C C A� `C O 0 C9 Ar •Z � �II DD ~ (IQ 0 0 ,-# r+ CD .D CA �- n 0 r �1 �. O A� cD cD v Q 0 C "! O n /O'd - C7 ICI C� ■-4-. �. 0 - CD CD X 00 :3 /-e= 0 CD 0 $4 =' ) �^c.CD rv0i CD .CD v0i 0. O vii `0• r p C 0 0 CD I w \ 1 CD 00 O UOQ r0.i s `C 2 C/3 O N N A� N 0 ~ �. � 0-h CO 0 : :-s 't fa, 0 Cr ¢, 0 = `D _ N MGM n 00 ¢' 0' p O0 a Q., r+ CD n '-' C. rn '.CI CD W ' U Q _ < 20s ' O• d 20 8 �, � O cD ccoUQ n V O ON .N. C7 CD + "S O� A� 0 - -. C 0 �- 1z, •UQ '+ UQ 0- ^�.r. '0'* D 0 0 CD �-Y CD 0 Va Cl. CD n cn El 4 N 0 rr Z O 0• O 0 b rA c Q. l `'C O. n^ A A "'s` 0 i] r 5. 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