NCG190018 DMR SW (3)

STORMWATER DISCHARGE OUTFALL(SDO)
GENERAL PERMIT NO.NCG190000
DISCHARGE MONITORING REPORT(DMR)
CERTIFICATE OF COVERAGE(COC)NO.: NCG19 0 O n 8 p G C VE AMPLE COLLECTION CALENDAR YEAR:
s ring
report is due at the Division no later than 30 days from
FACILITY NAME: Gov-l<)))1T 15eAt AUG 1 4he, 5e the facility receives the sampling results from the laboratory.)
SAMPLE COLLECTION NAME: 7A,Kc-'s (5, Hvt)fd/h)
CERTIFIED LABORATORY: �IJ1y j tr 1 Lab# CENTRAL FILESFACILITY COUNTY: �l T 7
Lab# DWR SECTION PHONE NO.: (2\-Z ) 7C.2--2-///
Part A: Specific Monitoring Requirements
Outfall Sample 00530 TPH by method 01119 01104 01094 01114
1664(SGT-HEM) •
No. Collection Date, Total Rainfall, Total Suspended Non-Polar Oil& Copper2'3,mg/L Aluminum2,mg/L Zinc2'3,mg/L Lead2'3,mg/L
mo/dd/yr inches Solids, mg/L Grease,mg/L
Freshwater - - 100 15 0.010 0.75 0.126 0.075
(Saltwater) (0.005) (0.095) (0.220)
Benchmarks
1 - FP,-8 Chits o,ZO" 5, 43 d.-5,o 0, b1),_ d'.'-l) () 1,39Y 40.005
1 - r7.1 -7 iii- 0As Lz.B 4-5,0 4_0 010 G.0.100 0. 17 X0,(705
' If a value is in excess of the benchmark,you must implement the Tier 1 or Tier 2 responses in the General Permit.
2 Total recoverable metal.
3 These benchmarks are water hardness dependant. Values shown based on a hardness of 50 mg/L.
Solvent Management Plan Certification:
Mail original and one copy to: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit requirement for
Division of Water Resources managing solvents,I certify that to the best of my knowledge and belief,no leak,spill,or dumping of concentrated solvents
Attn: Central Files into the stormwater or onto areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge
1617 Mail Service Center monitoring report. I further certify that this facility is implementing all the rovisions of the Solvent Management Plan
Raleigh,North Carolina 27699-1617 included in the Stormwater Pollution Prevention Plan."
01, 7! ( gf,ojI-
(Si ure of Permittee) (Date)
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." C
V J
(Signat r of Permittee) (Date)
Permit D t : 6/02/2015-5/31/2020 SWU-253-060515
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