NCG120100 DMR SW

guarterl Stormwater Dischar:e Monitorin: Re•ort
for North Carolina Division of Water Quality,General Permit No. NCG240000
Date submitted
42
CERTIFICATE OF COVERAGE NO. NCG O / 0 - / SAMPLE COLLECTION YEAR �01.'
FACILITY NAME 67' 2� JJl1,4� 4),4f T F aF b 4 /SB��I AMPLE QUARTER n Jan March pril-June July-Sept n Oct-Dec
COUNTY C413.4 g/2.115 or n Monthly' (month)
PERSON COLLECTING SAMPLES At1)je-elt sLGI .I S DISCHARGING TO CLASS f ORW HQW Trout 11:
LABORATORY Lab Cert.# fZero-flow nWater Supply SA
Comments on sample collectioyj or analysis: fOther
®u rc A-u xt i3 :0 a corK94)d5 e�4
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall 2 or No discharge this period3
Date Sample
Fecal Total Total Total Total Total
Collected' Outfall No. TSS COD coliform nitrogen phosphorus copper lead zinc pH
(mo/dd/yr)
Parameter benchmarks===> 100 mg;/L° 120 mg/L 1000 col./100 ml 30 mg/L 2 mg/L 0.007 mg/L 0.03 mg/L 0.067 mg/L 6-9
AVA- 4 _ -
RECEIVED
JUL I72015
CENTRAL FILES
DWR SECTION
' Monthly sampling (instead of quarterly) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2The total precipitation must be recorded using data from an on-site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
3 For sampling periods with no discharge,you must still submit this discharge monitoring report with a checkmark here.
'The TSS benchmark value is 100 mg/L; except when discharging to ORW, HQW, Trout, and PNA waters in which case the benchmark is 50 mg/L.
Permit Date: 10/1/2011-9/30/2016 Last Revised 12/02/11
Page 1 of 2

•
• Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Check
if No
Date Sample Outfall No. pH TPH using method Total Flow
Collected) 1664A SGT-HEM TSS Rainfall2 This Average New Motor Oil Usage
(mo/dd/yr) Period3
6-9 15 mg/l 100 mg/l4 - -
Footnotes from Part A also apply to this Part B
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❑
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 there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
"4//1.eeA) Ge2t/te_..i;
(Signature of Permittee) (Date)
Permit Date: 10/1/2011-9/30/2016 Last Revised 12/02/11
Page 2 of 2