HomeMy WebLinkAboutNCG060209 DMR SW (5)d.
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000 *01/
Date submitted 10 1%:s-- O O 0
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CERTIFICATE OF COVERAGE NO. NCG0
FACILITY NAME w+s — u1
COUNTY �4p v
PERSON COLLECTING SAMPL S a .SCS
LABORATORY NAV � 0 ch&� Lab Cert. #
Part A: Stormwater Benchmarks and Menitnrino Racidt-c
SAMPLE COLLECTION YEAR oR��R�NpQ j��S
FACILITY ACTIVITIES INCLUDE (check all that apply): RAF Gq��
DISCHARGING use/process animal/byproducts
RGI GTO SALTWATERS? DYES WO '�i�j G
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
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3The total precipitation must be recorded using data from an on-site rain gauge.
3 For sampling periods with no discharge at env 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 all per month? ❑ yes dno (fes complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results! nniv fnr fnAlltIne wersetwe % ee esl .-t ww....r._a_. _11 1.___&1
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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.
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 SE ION B.
• TIER 3: HAS YOUR FACILITY. HAD 4 OR MORE BENCHMARK EXCEEDEVINIO
FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES (� NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ EGIO AL QFFICE?' ,1� ES ❑
REGIONAL OFFICE CONTACT NAME:w�
Mall an original and one cony of this DMR, Including all "No Dischameu reports, within 30 days of Mcelnt of the tab, results lar at end of
monitoring rieriod In the case of "No Discharge" revorts) to:
Division of Water Quality
Attn: DWQ Central Files
161XMail Service Center
Raleigh, NC 27699-1613,
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
N 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."
(Signature of
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(Date)
Additional copies of this form may be downloaded at: http://Portal.ncdenr.ors/web/wa/ws/su/npdessw#tab-4
SWU-249
Last Revised: October 18, 2012
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