NCG060161 DMR SW

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT RECEIVED
for North Carolina Division of Water uality General Permit No. NCG060000
Datesubmitted NOV 6 2015
CERTIFICATE OF COVERAGE NO. NCG060 I G-4'7 G - SAMPLE COLLECTION YEAR 0-0 1CENTRAL FILES
n � DWR SECTION
FACILITY NAME Cxei � Pa.lana a 1�1C -Q.u�C . FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY 11�^ _ use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SCCAMPLES'� 0.Cx.l W o IDISCHARGING TO SALTWATERS? [—]YES ®NO
LABORATORYLab Cert. # lel G 419
Part A: Stormwater Benchmarks and Monitorine Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall Z or n No disrhnrnP thic narind3
,Outfall No. Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform', Enterococcil,
Colonies per 100 ml Colonies per 1b0 ml
Benchmark -
100 or 504
Within 6.0 — 9.0
120
30
1000 500
1'D 10 �S
') . 5D
(0.3s-
5. o
R
cc 91
�a.S.'o
-7. t,
00
S. o
unry appnes to tacinties wat 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 X no
Part B: Vehicle Maintenance Area Monitorine Results: only for facilities averaeine > 55 eal 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 -
unry appnes to tacwties that use/process meats.
?The 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.
(if ygs, complete Part B)
f-
SWU-249 Last Revised: October 18, 2012
Paize 1 of 2

*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 RI
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
OP
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
information, inr c i g po ilk
(Signature of Permittee)
true, te, and complete. I am aware that there are significant penalties for submitting false
fin a7dprisonment for knowing violations."
////,/Jj--
(Date/)'
Additional copies of this form may be downloaded at: _h_ttp://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-249
Last Revised: October 18, 2012
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