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Serpi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. N G200000 — Scrap Metal Recycling
Date submitted �J
CERTIFICATE OF COVERAGE N NC -05-4, 'iii 4
FACILITYNAME GC _ �r� h �y�/1'� nS phi M0otr11z ,
COUNTY 6 x r `r—t p
PERSON COLLECTING SAMPLES ;Std cv i
LABORATORY 5,0-�y, IIP, hl�n Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR X ) ( 5
SAMPLE PERIOD ❑ Jan -June July -Dec
` i% � or ❑ Monthly) (month)
' �DISCHA GING TO CLASS ❑ORW ❑HCtW ❑Trout ❑PNA
DEC d 1 2015 ❑Zero -flow ❑Water Supply [:]SA
❑Saltwater [Other w -M C,Ccf&k
� L BILES
CEoTR,4
DWR SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE 4
[�No discharge this period ?2 NO F �w
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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.
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 text, Table 3 or Table 4, identifying protected receiving water classifications where the more protective TSS benchmark applies.
s Stormwater discharges into receiving waters classified as saltwater are subject to the second listed benchmark.
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, quantitation 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.
Permit Date: 02/02/2015-12/31/2019 SWU-256, last revised 1/28/2015
Page 1 of 2
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
E�No discharge this period?Z
Date 5ain le:'-` 2 due rAll all
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Footnotes from Part A also apply to this Part B
N C-) F64
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier Z or Tier 3 responses. See General Permit.
FOR PART AND PART B MONITORING RESULTS.
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES INA ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO []
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES [j NO []
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days oLreceipt of the lab results (or at end of monitorina period
in the case of "No Discharae" reports) to:
Division of Water Resources
Attn: DWR 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 there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of
Permit Date:
1[3()/i�
(Datd)
SWU-256, last revised 1/28/2015
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