NCG060009 DMR SW (3)

SEMI-ANNUAL ST®RMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. N00060000
Datesubmitted
CERTIFICATE OF COVERGE NO. NCG060 0
FACILITY NAME 'P►r� Q&n T„r,
COUNTY
PERSON COLLECTING SAMPLES
LABORATORY -7BI— Lab Cert. # 3%7F/
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 901
FACILITY ACTIVITIES INCLUDE (check all that apply):
Vuse/process meats Rruse animal fats/byproducts
DISCHARGING TO SALTWATERS? DYES VNO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall z or n No dicrhnrnP this narinn3
Outfall No. s Sample -Collected,
mo/dd/yr-
TSS, WPH,
mg/L - Standard units
COD,,
mg/L
Oil and, Grease, ,
mg/L
Fecal Coliform , Enteroc`occil,
Colonies per 100.ml _ Colonies, per 100 ml
Benchmark -
100 or 50°` Within 6.0 - 9.0
120
� 30
1000 500
o ►6
.8
X30.0
N 1
1 /oo M,:
Unly applies to tacllltles that use/process meats.
ZThe total precipitation must be recorded using data from an on-site rain gauge
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. �Ila)
°See General Permit text, Table 3, Identifying the especially sensitive receiving water classifications where the more protective benchmark applies.4PR I b` 2016
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month
�"r '�9A44,Q441�ortl plete Part B)
O"'3S1148 Ulm,
'Outfall No: Sample, Collected, _ Oil, and Grease, TSS, pH, New Motor Oil Usage,
mo/dd/yr mg/L mg/L Standard units Annual average gal/mo
Benchmark '' - 30 100 or 504 6.0-9.0 -
Only applies to facilities that use/process meats.
ZThe total precipitation must be recorded using data from an on-site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here
°See General Permit text, Table 3, Identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SWU-249
Last Revised- October 18, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
O A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS SEE PERMIT PART II SECTION B.
2 EXCEEDANCES INA ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? 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 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, 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 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, includig.&the possibility of fines and imprisonment for knowing violations."
(Signature of Perhiittee)
,—( 14
(Date) 4
Additional copies of this form may be downloaded at: http://portal,ncdenr.org/web/wq/ws/su/npdessw#tab-4
S)VU-249
Last Revised: October 18, 2012
Page 2 of 2