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SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted Lf — % ^ IS
CERTIFICATE OF COVERAGE NO. NCG06 OI —b Ri�'�
���®SAMPLE COLLECTION YEAR /
FACILITY NAME ,� / e- O �hC. 1.. FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY v n C et -APR 0 8 X15 ❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLECT NG SAMPLES DISCHARGING TO SALTWATERS? DYES NVO
LABORATORY 16-4, 7c -Ai6a/, Lab Cert.#T?1"PWg
PLEASE REMEMBER TO SIGN
/ON THE REVERSE
Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall z �!' /Tnr n Nn rlicrhnrnn Chic nvrinrP
Outfall No. Sample Collected, • TSS, pH, 'COD, Oil and 'Grease, ' Fecal Coliform Enterococci ,
mo/dd/yr mg/L Standard units mg/L mg/L� Colonies per 100'ml Colonies per 100m'[
Benchmark - 1000r50' Within 6.0 – 9.0 120 30 1000 500.
3-19-1 G• 23
APR 0 1 /015
only applies to facilities that use/process meats. UtN I RAL FILES
3The total precipitation must be recorded using data from an on-site rain gauge. DWR SECTION
3 For sampling periods with no discharge at anv outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes Xno (if yes, complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
-Outfall No. Sample Collected, Oil and Grease,
mo/dd/yr mg/L
TSS,
mg/L -
pH, New Motor Oil Usage,
Standard units Annual average gal/mo
:Benchmark 30
100 or 50
6.0;– 9.0 -
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on-site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
S W U-249
Last Revised: October 18, 2012
Page 1 of 2
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Ruality General Permit No. NCG060000
Date submitted 44
CERTIFICATE OF COVERAGE NO. NCG06 OI q b
FACILITY NAME j J / 1 0_D �11C•
COUNTY v n C e --
PERSON
PERSON COLLECT NG SAMPLES -r. �-.e-d -e S
LABORATORY ACS n q I t -hiCa/ Lab Cert. # q.Z2V9-Q V6C1 Z
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR -� D % L%
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? DYES XVO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall 2 7. 1 gr ❑ No discharge this period'
Outfall No. Sample Collected, , , TSS, pH, COD, Oil and Grease, Fecal Coliform Enterococci
mo/dd/yr mg/L Standard units mg/L mg/L-' Colonies per 100'ml Colonies per 100 ml !
Benchmark - , 100 or 504 Within 6.0 - 9.0 120 30 1000 500.
f 6,9 ,
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on-site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per,month? ❑ yes Xno
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month
-Outfall No. Sample Collected, Oil and Grease,
mo/dd/yr mg/L
TSS,
mg/L •
pH, New Motor Oil Usage,
Standard units Annual average gal/mo '
'Benchmark - 30
100 or 50
6.0-9.6 -
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on-site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(ifyes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2
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SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted �q —% —is
CERTIFICATE OF COVERAGE NO. NCG06 0 % L 6 SAMPLE COLLECTION YEAR � O % .J
FACILITY NAME A D11C. FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTYy !1 C d !h J., t ❑ use/process meats ❑ use animal fats/byproducts
PERSON COLLECT NG SAMPLES - o-.' 2T e e -LI. i DISCHARGING TO SALTWATERS? DYES NVO
LABORATORY AC{- 4nef 1 oiGa/ Lab Cert. #jZjjr20A 81061.7
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall z> • 1Y or n No discharae this narind3
Outfall No. Sample Collected, TSS,
mo/dd/yr mg/L
pH; COD, Oil and Grease, Fecal Coliform,,, Enterococci",
Standard'units mg/L mg/L- Colonies per 100 ml Colonies per 100 ml'
Benchmark - 100 or 504
Within 6.0 - 9.0 120 30 1000 500
- -!f • D
8.06 9 21 O
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on-site rain gauge.
3 For sampling periods with no discharge at anv outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes Yno
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No. Sample Collected, Oil and Grease,
mo/dd/yr mg/L
-TSS,
mg/L
pH, New Motor Oil Usage,
Standard units Annual average gal/mo
Benchmark - 30
100 or 50
6.0, 9.0,
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on-site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
S W U-249
(if es complete Part B)
Last Revised: October 18, 2012
Page 1 of 2
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submittedg —/ ^ / S
CERTIFICATE OF COVERAGE NO. NCG06 OI qt?
FACILITY NAME 4 , / Q O a1NC.
COUNTY v n C e--
PERSON
GPERSON COLLECT NG SAMPLES
LABORATORY AC -t. 4nv1jV,0Ve41 , Lab Cert. #92z 5/20.2 aoDy
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR -� D % ✓
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? DYES 2�40
PLEASE REMEMBER TO SIGN ON THE REVERSE --)
Total event rainfall 27• JYor ❑ No discharge this period'
Outfall No. Sample, Collected,, TSS, pH,
mo/dd/yr mg/L Standard units
COD, ,; Oil and•Grease,' Fecal Coliform,, Enterococci ,•'
mg/L mg/L Colonies per 100 ml Colonies per 100 ml
Benchmark - 100 or 50 Within 6.0 —'9.0
120 JO' 1000 500
-7.
.v
ol of 4 41
01
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on-site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes Xno
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month
Outfall No. Sample Collected, Oil and Grease,
mo/dd/yr mg/L
,TSS,
mg/L
pH, New Motor Oil Usage,
Standard units Annual average gal/mo
Benchmark - 30
100 or 50
6.0-9.0 -
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on-site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2
*FOR PART A AND PART B MONITORING RESULTS:
0 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 ❑ NOA
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, NC 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."
(Date)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2