NCG060102 DMR SW

i
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted 9 - a I - 15
CERTIFICATE OF COVERAGE NO. NCG060 J_QL_@, 1
FACILITY NAME 11 ALLe- rmS ZrJL —E eIQ $ r�n4S
COUNTY MoorP,
PERSON COLLECTING SAMPLES E.oVV
&raLGreem j(;ordon Sg o)
LABORATORY MeriizcbaZNC. Lab Cert. # I105
.
Part A: Stormwater Benchmarks and Monitor
TSS,
Outfall No. Sample Collected,
mo/dd/vr ma/1
Benchmark
100 or
Results
PH,.
Standard units
Within 6.'0=9:0
.; 5
COD,
120
9 to
RECEIVED
SEP 2 9 2015
t rENTRAL FILES
SAMPLE COLLECTION YEAR 01015 nV'R, SECTION
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ❑ use animal f is/byproducts
DISCHARGING TO SALTWATERS? OYES QNO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall 2 or ❑ No discharge this period
Oil and Grease, Fecal,Coliforml,. Enterococcil,
mg/L' Colonies per,100 ml Colonies per 100 ml 1.
30 ` 1000 • 500
' Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on-site rain gauge.
aFor sampling periods with no discharge at anv 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 yes ❑ no (if es complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities avera
Outfall'No. Sample',Colledted"'Oil and'Gre'ase, TSS,
mo/dd/yr ..; rrig/L, -,
Benchmark - 30 100 or 504
1 0$ 5 $
a Ac A Iti
ig > 55 gal of new motor oil/month
pH, New Motor Oil Usage,
`-•Standard units- . Annual'averagetgal/mo
6.0-9.0 _
1.01.5aql c1h t n.
' Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on-site rain gauge.
aFor sampling periods with no discharge at anyoutfalls, 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.
I
SWU-249
Last Revised: October 18, 2012

*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:
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."
CA� -11 n.eg*u�- °t 1 a 1 115
(Signature of Permittee) (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-249 I
Last Revised: Oc r 18, 2012
` r1age 2'6f 2