NCG120013 DMR SW (8)

Semi-annual Stormwater DischaEge Monitoring Report
for North Carolina Division of Water nail y General Permit No. NCGI20000
Date submitted t1 30 , 15
CERTIFICATE OF COVERAGE NO.
FACILITY NAME WKew�fw
-ecLd 1Il TC.ik. ('a���SU� �
COUNTY G uiWbf-
PERSON COLLECTING SAMPLES �kCAV 4�
LABORATORY ��.�� Lab Cert. # (-
Comments on say�ple collection or analy$is:
001 ai4 au.-IN
om"-&_!'1 k0Ur5 ort 1. IS
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2-015
SAMPLE PERIOD 0 Jan -June []July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout []MA
❑Zero -flow ©`Nater Supply ❑SA
RECEIVED ❑Other
DEC 0 4 7-015 PLEASE REMEMBER TO SIGN ON THE REVERSE �
CENTRAL FILES
DMR SECTION
l-' No discharge this period?Z j
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001
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
' For sampling periods with no discharge at any single outfall, you must still submit this discharge' monitoring report with a checkmark here.
3The 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,:thev must be reported in the format.' "<XX ms/V;wh'e're XX -is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where'fecal coliform results exceed the dilution upper limit, report the result as ">XX".
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: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012
Page 1 of 2

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water QLlali y General Permit No. NCG120000
Date submitted I I 'J© lS
CERTIFICATE OF COVERAGE NO. NC 12(0 0 ( 3
FACILITY NAME W�tkJL 56-�'t 1C� ee�sb��)
COUNTY (jU'k orC
PERSON COLLECTING SAMPLES C'tY L --t vdt t�
LABORATORY Ktrt-'" Lab Cert. # t65
Comments on sample collection or analysis:
Part A: Stormvuater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Zo 15
SAMPLE PERIOD O Jan -June [V] July -Dec
or El Monthly' (month)
DISCHARGING TO CLASS OORW OHQW OTrout OP;NA
OZero-flow [�16ater Supply OSA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE —>
F-1 No discharge this period?Z
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1 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.
3The 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 ms/L", where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
(Vote: 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: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/.2012
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
[�No discharge this period?2
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001
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:
0 A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
0 2 EXCEEDANCES INA ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
0 TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC S FOR THE SAME PARAMETER AT ANY1 ONE OUTFALL? YES RrNO ❑
IF YES, HAVE YOU CONTACTED THE DWQ11EGI9NAL OFFICE? YES JVJNOE1
REGIONAL OFFICE CONTACT NAME: C o e— j s¢r���t
Mail an original and one coov of this AUK including all "'Wo Discharge" reports. within 30 dais 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, 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.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
U/
(Signature of Permittee)
///.)a/ 004f
(Date)
Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012
Page 2 of 2