NCG030567 DMR SW (7)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted 0)- 13- a OI(A
CERTIFICATE OF COVERAGE NO. NCG03,
FACILITY NAME ( (TD I llor -
COUNTY `
PERSON COLLECTING SAMPLES 80
LABORATORY Lab Cert. #
on sample collection or analysis:
I- I i _ , I —
W i -I h n 30 m n 0-6
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR Q Q /S
SAMPLE PERIOD ❑ Jan June Duly -Dec
or ["Monthly' J ".Q.n ha4' (month)
DISCHARGING TO CLASS []ORW []HQW []Trout []PNA
ECE1ED []Zero -flow QWatersupply ❑SA
[]Other
JAN'1 2U.
CENTRAL FILESLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
®WR SECTION
VNo discharge this period?Z
Outfall No.
Benchmarks =__>
Date Sample
Collected 1
(mo/dd/yr)
_
24-hour rainfall
amount,
Inches
-
Total Suspended Solids
100 mg/L or 50 mg/L4
pH, Copper Lead
Standard units
6.0; 9.0 0.007 mg/L 0.03 mg/L
Non -Polar O&G/
Zinc Total Petroleum
Hydrocarbons
0.067 mg/L 15 mg/L
Total Toxic;
O anicss
�
1 mg/L
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceeaance Tor the same parameter at the Salim Oul.+an.
Z 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, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2012-10/31/2017 SWU-245, last revised 10/25/2012
Page 1 of 3

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 IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART If SECTION B.
0 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 original and one coov of this DMR including all "No Discharge" reports within 30 days of receipt of the lob 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.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
C
(Signature 9�-,rrnittee)
Permit Date: 11/1/2012-10/31/2017
( ate)
SWU-245, last revised 10/25/2012
Page 3 of 3