NCG060009 DMR SW (2)

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted //- Ael - /.5
CERTIFICATE OF COVERAGE NO. NCG06Q Q Q 1
FACILITY NAME P- j2
COUNTYKo%x ,
SAMPLE COLLECTION YEAR g'ZO /LS
FACILITY ACTIVITIES INCLUDE (check all that apply):
Z use/process meats r2l use animal fats/byproducts
PERSON COLLECTING SAMPLES Rei,rjn Tv I2c' R.ECEIV G TO SALTWATERS? ❑YES ZNO
LABORATORY� f. %uirome_r4o�_l Lab Cert. # 37
NOV 3 0 2015 PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results nie,n CENTRAL FELE- Total avant rninfnll 1 _ 0S nr n Nn d;crhnrnc rl„c nnr;n
-
Outfall No. Sample Collected, TSS, pH, COD,
mo/dd/yr mg/L Standard units mg/L
-
it and Grease,
mg/L
_..., _.. - - - ... u ................ y.. „., rte. ,....
Fecal Coliform', Enterococcil,
Colonies per 100 ml Colonies per 100 ml
'Benchmark - 100 or 50 Within 6.0 — 9.0 120
30
1000 500
I • 9•8 15 36Yda,4 5-q IT. c
p
8 500
vrlry dNNues w IdUlmes mat 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 55 gallons of new motor oil per month? ❑ yes Zno
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, pH, New Motor Oil Usage,
mo/dd/yr mg/L mg/L Standard units Annual average gal/mo
Benchmark - 30 100 or 50 6.0-9.0 -
__
–•••� •-111 -1 — �a�n,uca 1111L III/�/IVICDS IIICdtS.
The total precipitation must be recorded using data from an on-site rain gauge.
43For 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.
(ifyes• complete Part B)
S WU-249
Last Revised: October 18, 2012
Page 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
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one copy of this DMR including all "No Discharge" reports, within 30 days of receipt of the lab results for 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, includi th pgas bility ones and imprisonment for knowing violations."
(Signature of ermittee) (Da )
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-249
Last Revised: October 18, 2012
Page 2 of 2