NCG060095 DMR SW (2)

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina, Division of Water Quality General Permit No. NCG060000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG06'0 L ct SAMPLE COLLECTION YEAR'
FACILITY NAME FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY ,n; on use/process meats Wuse animal fats/byproducts
PERSON COLLECTING SAMPLES WL., bT DISCHARGING TO'SALTWATERS? AYES 'NNO.
LABORATORY QAC:E Lab Cert. #
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitorine Results Total event rainfa111._ I nr n Nn r/icrhnrnp this nPrin
;;Outfall No } Sample Collected; TSS,
'•.;.
/Yr..
pH, COD, , 4 a O�Iand,Grease, �, ' FecaLColiform
'r �J s .� F34 1`s* ,_-. ,�' ; I <`
mg/L Colornes*r 100.rn
� Standard'units ..' mg/L�u ': '„ ..
Enterococci
.-
.... I.
;. Colonies per 100 ml
Benchmark,;;100or50. },.
;AW�thm60...•90 ?.jNi,=r.i°20_,.,'.,,,.._}`s ...30 ^.,.._ T_r� ,... 1000
500,
If) IP _
q14 KM Ism
rl
umy appues to tacnities tnat use/process meats.
zThe total precipitation must be recorded using data from an on-site rain gauge.
s For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
45ee 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 yes, complete. Part B)
Part Bi Vehicle Maintenance Area MonitoringResults: only for facilities averaging > 55 gal of new motor oil/month
Outfall No Sample Collected, Oil and Grease,; 2 a"TSS, New Motor Oil Usage,._.
mo/dd/,yr , •, .mg/L , `„ mg/L }, ; S.a Standard'umts Annual average gal/mo
Benchmark f f 30 t 100 or -50 6 0 9 0Me-
e:
Umy dppnea w rdunuea urdL ube/prmebs rnedta.
2 The total precipitation must be recorded using data from an on-site rain gauge.
a For sampling periods with no discharge at any outfalls; you must still submit this discharge monitoring report with a checkmark here
1. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
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SWU-249 Last Revised: October 18, 2012
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*FOR PART A AND PART B MONITORING RESULTS:
o. 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? I 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
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
I
Attn: DWQ Central Files
1617 Mail Service Center
.I
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 inlaccordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the
ly responsible for gathering the information, the information submitted is,
person or persons who manage the system, or those persons direct
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 Permittee)
31,
(Date)
Additional copies of this form may be downloaded at: htti)://portal.ncdenr.org/web/wq/``ws/suLnpdessw#tab-4
Last Revised: October 18, 2012
SWU-249 j Page 2 of 2