NCG240004 DMR SW (2)

Quarterly Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG240000
Date submitted h-I/3o//5
CERTIFICATE OF COVERAGE NO. NCG24 O 0 Q a SAMPLE COLLECTION YEAR 02015
FACILITY NAME _S N 01( i ( SAMPLE QUARTER f rJan-March ❑April-June ❑July-Sept ❑Oct-Dec
COUNTY �tntp,So or ❑ Monthly' (month)
PERSON COLLETING SAMPLES �w��onk2�gcke5 DISCHARGING TO CLASS ❑ORW DHOW ❑Trout ❑PNA
LABORATORY icG c 14.00)y�tca) Lab Cert.# ❑Zero-flow (Water Supply ISA
Comments on sample collection or analysis: Pother . SkJa■•,P
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall2 1. 6 or U No discharge this period3
; i I! 3
a { � a 1,11'1:T
YY
I :1T-j 11 , -I
4ib) { ,� :II1 ii I i( i� li'I� {hi k,,0i i( il,ik[:: 01 , i(0),,1 l I 1ir-I i. i Ii ,i l Ho) rl ! iE ,i II ,ili I, 1 131?° °� ��) ` # I11 i ) I, i 11 ; ;, 1 il Ii : :
It .�i.Q /AJ)161.: )_a r�Irli12 a,l`:�+ i I,:, ''i'j11) .9 1 -. II i.,lp), I i Ihr'p p, , f,PS'1� I.. p .' , I 1, 3,E . I (d' I ; :.. .;1 1 . '
�r t (I�t) 1. a A q{ , ,,k. Irll.,/1 ,I11.1� , ,± 1)�,L 1. III i l j La ICI d I klpjl.+,� tI j iUl .r/� U �✓/i�,1.1� : 149
"%fa 6Aall / .-'695 /3/0 70000 /, f !! , o/ . 3 ?? 7. 5
d , 6® 2 / 5 2_ Nom , r-000 r��t� . 95 .005 7'S mommiratuatimm
=um magag--imum 1-----,111-e TEINEU 41PRI
Pk ILEMill WWI
1111.1.11AMME MK=
IIMMENSEUla
1 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.
j
Ii 'I, 1
lil 111 I�11(Ihi+,Utl:j,ltt,y+i- 'I, '11-1;.11 I,il>I'I I
'NM 1 lii�+ll Il.toliili:111Whi, I 1' i II : t III+fI + s i;\'!I I S !ICI\ I I'+1+1<+Iltn)litii),I (•;
(tt+lil 1,i(t+it `' iq,jni \,,,t,,rrrl;rl'I&',I I' II l+i•i111+ il: I ! Y
(V {. ih}/It))
itli °I'I,
I _.l i'-1 .:ll :iI! ,1,li:At._ JI ,Yais +:!1 iili:': IL. . .: •, -1 1I , I i i 11
• ling
MININIIIIIIIIII
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 sign ficant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations."
y 3,
(Signature of Permi (D:te)
Last Revised 12/02/11
Permit Date: 10/1/2011-9/30/2016 Page 2 of 2