NCG210355 DMR SW (13)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina DEMLR General Permit No. NCG210000
Date submitted
CERTIFICATE OF COVERAGE NO. N G21D 3 S SAMPLE COLLECTION YEAR �� I
FACILITY NAM �OVlSIGL►1a �Gtu�1 c SAMPLE PERIOD ❑ Jan -June Q July -Dec
COUNTY or Monthly' (month)
PERSON COLLECTING SAMPL S DISCHARGING TO CLASS ❑ORW RHQW Trout QPNA
LABORATORY %oUiStr� �Ct>~�r Lab Cert: # Zero -flow ❑Water Supply ❑SA
Comments on�sample.collection or analysis:Other GtSS C
PLEASE REMEMBER TO SIGN ON THE'REVERSE -�
Part A: Stormwater Benchmarks and Monitoring Results (Monitoring is required only if the facility stores exposed accumulations of sawdust, wood chips,
bark, mulch, or other similar material on site for longer than seven (7) days.)
0 No discharge this period?'
De Sample
at24 hour rainfall
Outfall No r
Collected r amount,
(mo/dd/yr) Inch S3.. Chemical;'Oxygen Demand Total Suspended Solids
Benchmarks > - 120 mg/L 10d mg/Lor 50 mgJl4
OO AARAa S
002 I'Llmn #is Q_,.17 39Y71s
3 /!7
e+f 0, yq .
00
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
'The total precipitation must be recorded using data from an on-site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is'the numerical value of the
detection limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 8/1/2013-7/31/2018 SWU-245, last revised 7/31/2013
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Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
U No discharge this period?2
I— 1 T is tli Q u dv Q� f' I1 � w� water Qr`f' P�ar�'.
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
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 IKNO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REG 10 AL OFFICE? YES M NO Q
REGIONAL OFFICE CONTACT NAME: Ge-tim-- -5/hl w5lzo
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, North Carolina 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 si nificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
e..
(Signature of Permittee) (Da )
Permit Date: 8/1/2013-7/31/2018 SWU-245, last revised 7/31/2013
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