NCG060131 DMR SW (6)

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT RECEIVED
for North Carolina Division of Water Quality General Permit No. NCG060000 DEC 15 2014
Date submitted
CERTIFICATE OF COVERAGE NO. NCG 6 DENR-LAND QUALITY
FACILITY NAME � / L- SAMPLE COLLECTION YEAR a ni U STCRMATER PERMITTING
FACILITY ACTIVITIES INCLUDE (cher 11 that apply):
COUNTY C �, • leo r.r,(! � use/process meats arse animal fats yproducts
PERSON COLLECTING SAMPLES �' S S DISCHARGING TO SALTWATI�RS? []YES [�1�0
LABORATORY__ IL-1 �M Lab Cert. p
Part A: Stormwater Benchmarks and Monitoring Results
Outfall No. Sample Collected, TSS, pHA
mo/dd/yr mg/L Standard units
Benchmark - 100 or 50 Within 6.0 — 9.0
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Totalevent
C
No discharge this period'
OD, tuin ano cirease, Fecal Coliform`, Enterococcal,
mg/L mg/L Colonies per 100 ml Colonies per 100 ml
120 30 1000 500
/fit o
Only applies to facilities that use/process meats.
3The 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.
Did this facility perform Vehicle Maintenance Activities using more than SS gallons of new motor oil per month? [] yes no (if yes, complete Part B)
Part B: Vehicle Maintenance Area
Outfall No. Sample Collected,
mo/dd/yr
Benchmark
3ring Results: only for facilities
6Fand
Grease, TSS,
30 1 100 or
> 55 gal of new motor oil/month.
PH, New Motor Oil Usage,
Standard units Annual average gal/mc
6.0-9.0
' Only applies to facilities that use/process meats.
3The total precipitation must be recorded using data from an on-site rain gauge.
4 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.
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 Quality eneral Permit No. NCG060000
Date submitted /
CERTIFICATE
OF COVERAGE NO. NCGG 6_4 / L SAMPLE COLLECTION YEAR c2 al 'J
FACILITY NAME i% rt\" c d }�• � � FACILITY ACTIVITIES INCLUDE i;chec II that apply):
COUNTY,��o mac( pp yI•
��-----+'n 2❑use/process meats se anima COLLECT[NAMPLES l fatyproducts
DISCHARGING TO SALTWATERS? []YES BNo
LABORATORY }�-�' Z �M Lab Cert. #
Part A: Stormwater Benchmarks and Monito
Outfall No. I Sample Collected, TSS,
Benchmark I -_____r 100 or
Results
PH,
Standard units
Within 6.0— 9.0
COD,
120
PLEASE REMEMBER TO SIGN ON THE REVERSE
Total event rainfall 1 l,Qr ❑ No discharge this peric
Oil and Grease, Fecal Coliform , Enterococci=,
mg/L Colonies per 100 ml Colonies per 100 ml
—30 1000 500
' Only applies to facilities that use/process meats.
The total precipitation must be recorded using data from an on-site rain gauge.
a 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.
Did this -facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Q yesno (if es 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, TSS,
mo/dd/yr m L and PH, New Motor Qil Usage,
Benchmark g/ mg/L Standard units Annual average gal/mo
30 100 or 50 .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.
3For 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.
SWU-249
List Revised: October 18, 2012
Pagc 1 of 2

*FOR PART A AND PAR'I`D MONfFORING RESULTS:
o A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. ;. SEL" PERMIT PART II SECTION G.
Q � c_
a 2 EXCEEDANCE.S INA ROW FOR THE SAME PARAMETER AT Ti -1L SAME OU--- — IFf,
TIER 3: FIRS YOUR FACILITY HAD OR MORE BENCHMARK E)(CEEDENCE;IFOPL 1 M�U�L31:CR 111:1, 2 11EQUIRLMI_NTS. SEE PERMIT PART I1 SECTION B. 1�
�T ;I�'�AME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO Qf�
IF YES, 14AVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES � NO LJ
REGIONAL OFFICE CONTACT NAME:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1F;17
YOU MU57"5I6'NTWIS
CL -
"I
FOR AIVY 11V1-0f?MAT10N f ENO11TEp.
"I certify, under penalty of law, that this Ciocument and all attachments were Prepared under my direction or supervision in accordance with a
systenl designed to assure that qualified personnel Properly gather and evaluate the inforn-iation 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 aril aware that there are significant Penalties for submitting false
information, inClUCling the possibility of fines and imprisonment for knowing violations."
0
(Si tore of f�err` ee) --._ ICZ- 10
• (Date)
Additional Copies of this form niay he downloaded at: htt 3: /portal ncdenr;or wLh we w su n xles-,;Lviltah_n
��_ ' LOLL l�
S W U-21 49
Last Revised: October IS. 2012
Page 2 of 2