NCG060114 DMR SW (2)

7
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted 11 I C1 Isots
CERTIFICATE OF COVERAGE NO. NCG06 01 I "1 ff \ \
FACILITY NAME N-\1 CJ& M0.X_WTQ E- 7\nc�1nC-
COUNTY 1h'0 , N C -
PERSON COLLECTING SAMPLES RaV\d-A\ kM oa )NkgcXa(lAAJS/Awu�l Nnuj
LABORATORY WQOI ac LabyAA-0Yi1t Lab Cert. # J NC
Nc T 3�TkOF
USDA 3 -SI
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2o�5 NOV 16 ZZ
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal fats/byproducts" " 'T'.M r1L'L_ 3
DISCHARGING TO SALTWATERS? DYES ®NO jv% , `.('TION
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
1 %,
Total event rainfall 0. g 2 or ❑ No discharge this period3
Outfall No. Sample Collected, TSS,
mo/dd/yr mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease, Fecal Coliform", Enterococcil,
mg/L Colonies per 100 ml Colonies per 100 ml
Benchmark - 100 or 50
Within 6.0 — 9.0
120
30 1000 500
2 10 28 -1015 3y. }
,fig
25 . °►
oe
< 5.00
1 Only applies to facilities that use/process meats.
ZThe 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 55 gallons of new motor oil per month? ❑ yes 0 no
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 -
1 Only applies to facilities that use/process meats.
ZThe 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
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*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�
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME: NIA
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 perso ` o nage the system, or those persons directly responsible for gathering the information, the information submitted is,
to the bes my knowl dge and true, acc te, and complete. I am aware that there are significant penalties for submitting false
iNorma 'on, includin he p ibility ofI an mprisonment for knowing violations."
S
(Sig atur of Permitt ) (Dat
Additional copies of this form may be downloaded at: http:Hportal.ncdenr.ore/web/wq/ws/su/npdessw#tab-4
SWU-249
Last Revised: October 18, 2012
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