NCG190018 DMR SW (12)

STORMWATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG190000
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE OF COVERAGE (COC) NO.:-NCG19® D❑0®3__ SAMPLE COLLECTION CALENDAR YEAR:
i (This monitoring report is due at the Division no later than 30 days from
W
FACILITY NAME: ��' `�- ii fTEdate the facility receives the sampling results from the laboratory.)
SAMPLE COLLECTION NAME: Mme-, c- 14m-wo CIV f
FACILITY COUNTY: TiT
CERTIFIED LABORATORY: E/00 ;QjplF�i J, )&-- Lab # io DEC C 4- /o ., -
Lab # PHONE NO.: (M)
Part A- Specific Monitoring Rc uirements CENTRAL FILE
Outfall
No.
Sample
Collection Date,
mo/dd/ yr
Total Rainfall,
inches
00530
TPWl;fYkdhdi&dU
1664 (SGT -HEM)
I ION 01119
01104
01094
01114
Total Suspended
Solids, mg/L
Non -Polar Oil &
Grease, mg/L
CopperZ' 3, mg/L
Aluminum 2, mg/L
Zinel, , mg/L
Lead 2, 3, mg/L
Freshwater
(Saltwater®
Benchmarks
-
-
100
15
0.010
(0.005)
0.75
0.126
(0.095)
0.075
(0.220)
Ca Ti l�_
6,
--5
0.c.)lU
�•S
�•�ls
L O.Ck9�
o-oio
q%0�
p 036
ccD.ov
If a value is in excess of the benchmark, you must implement the Tier 1 or Tier 2 responses in the General Permit
Total recoverable metal
3 These benchmarks are water hardness dependant Values shown based on a hardness of 50 mg/L
Solvent Management Plan Certification: DEC 0 4 2015
Mail original and one copy to: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit requirement for
Division of Water Resources managing solvents, I certify that to the best of my knowledge and belief, no leak, spill, or dut TcRAJ. ceHtraiSd solvents
Attn Central Files into the stormwater or onto areas which are exposed to rainfall or stormwater runoff has occu AnS261`j`i N last discharge
1617 Mail Service Center monitoring report I further certify that this facility is implementing a the provisions of the Solvent Management Plan
Raleigh, Noith Carolina 27699-1617 included in the Stormwater Pollution Prevention Plan " _
of Pvrlvlittee (Date)
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 imprisonme9rfor lowing violations."
(Signature of Pe ttee) l' (Date)
Permit Date 6/015-5/31/2020 SWU-253-060515
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