NCG120013 DMR SW (19)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Chu ityyGeneral Permit No. NCG120000
Date submitted Q 102 t5
CERTIFICATE OF COVERAGE NO. NCG121.0 0 I 3
SAMPLE COLLECTION YEAR (5
W il I'GL Sf-"e% �vl l t i'� '�k, of GrC4rlt 1p) SAMPLE PERIOD ❑Jan-June ❑July-Dec
FACILITY NAME � 1 � uSk
COUNTY Gull-crol or �Nlonthly u9 (month)
PERSON COLLECTING SAMPLES GY L-Icif�i+�� DISCHARGING TO CLASS ❑ORW ❑HQW ['Trout ❑PNA
LABORATORY RPX ktc- I Lab Cert.# I65 RECEIVED ❑Zero-flow 2Alater Supply ❑SA
Comments on sample collection or analysis:( SEP 0 4 2015 ❑other
Fec. col appears .o be an gnOalaly.
PLEASE REMEMBER TO SIGN ON THE REVERSE -
CENTRAL FILES
DWR SECTION
Part A:Stormwater Benchmarks and Monitoring Results
No discharge this period?2
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o 0 4— era 18 (5 1.03 q? > 87t 000 1
1 Monthly sampling(instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall,you must still submit this discharge monitoring report with a checkmark here.
3The 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.
4 See General Permit text,Table 3,identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. for example;do not report Below.Detection Limit,:BDL,<PQL, Non detect, ND,or other similar non-
numerical format. When results are-below the applicable limits,they must be reported in the format,”<XX'me/L",where XX is the numerical value of the
detection limit,reporting limit,etc. in mg/L.,Conversely,where fecal coliform results exceed the dilution upper limit, report the result as">XX".
Note: If you report a sample value in excess of the benchmark,you must implement Tier 1, Tier 2,or Tier 3 responses. See General Permit text.
Permit Date:11/1/2012-10/31/2017 SWU-248,last revised 10/25/2012
Page 1 of 2

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