NCG030306 DMR SW (2)

Semi-annual, Stormwater Discharge. Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
CERTIFICATE OF COVERAGE NO. N.CG030306
FACILITY NAME Jacobsen, A Textron Company
COUNTY Mecklenburg
PERSON COLLECTING SAMPLES: NA
LABORATORY: NA Lab Cert. #NA
C t sam In collection or anal sic•
Date submitted
SAMPLE COLLECTION YEAR 2015
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
RCENor ® Monthly' February (month)
EC
ISCHARGING TO CLASS ❑ORW ❑HQW OTrout ❑PNA
MAR 4 9 2T5 ❑Zero -flow ❑Water Supply FSA
ommen s on p y_ MOther C
FILES
None C��TSEG-TION
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
® No discharge this period?2
Outfall No.
Date Sample
Collected 1
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
pH
Standard units
Copper
Lead
Zinc
Non -Polar 0&G/
Total Petroleum
:Hydrocarbons
Total Toxic
Organics s
Benchmarks =__>
-
-
100•mg/L or 50 mg/L
6.0-0.0
.0.007.mg/L
0.03 mg/L
0.067, mg/L
15 mg/L
1 mg/L
SW001
NA
NA
NA
NA
NA
NA
NA
NA
--
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Z 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, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture. cathode ray tubes: For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 1 -of 3

ntion Plan
ay so
and the
rement
or TTO
Facilities that incorporate a solvent management plan into the Stormwater Pollecompoundsnusedsnd he,other elemenits listed in the General ring
may be waived. The solvent management plan shall include a list of the total toxic organic
aiver, the discharger shall sign the following certification statement:
Permit. For those facilities electing to employ the TTO monitoring w
al toxic organics
"Based upon my inquiry of the person or persons directly fno dumping of concentrated toxic organics responsible
l ifor lan cs ing compliance with i to the stormwater opareas which arepermit monitoring reuirement for texposed to rainfall or
(TTO), I certify that to the best of my knowledge and belief, P
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
CHRIS WISSINGER
Name (Print name)
FACILITIES MANAGER
Title (Print tittle) _
(Signature) (Date)
Note: Results must be reported in numerical format. Do not report Belowit BDL,
m
OXX 4Ll'where mN re XX,ND, or other is the numerical' vllar non -numerical.
alue of the detection
format. When results are below the applicable limits, they ust be reported in the forma
limit, reporting limit, etc. in mg/L.
(Vote: 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.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per
'No discharge this period ?2
DateSample 24-hour rainfall
Outfall-No.Collected' amount, Non -polar O&G/TPH by Total.Suspended Solids PH
(mo/dd/yr) Inches' EPA_ 1664 (SGT -HEM)
15 mg/L 100 mg/L or 50 mg/L* 6.0 — 9.0 SU
Benchmarks =__> - NA NA
NA NA NA NA
Footnotes from Part A also apply to this Part B
sitive receiving water classifications where the more protective benchmark applies.
* See General Permit text, Table 5, identifying the especially sen
SWU-245, last revised 10/25/2012
Permit 'Date:11/1/2012-10/31/2017 Page 2 of 3

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.
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 ANYONE OUTFALL? YES '0 NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES Fli 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.ldb results for at end of monitoring perlod
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 forgathering 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."
(Signature of Permittee)
Permit Date: 11/1/2012-10/31/2017
'3 - 2 -� I �)
(Date) `
SWU-245,11ast revised 10/25/2012
Page 3 -of 3