NCG030440 DMR SW (8)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted �i%s a0/(0
CERTIFICATE OF COVERAGE NO.
FACILITY NAME TrM V e.s Sft d TrMo.J PeA l . PIA..,t
COUNTY Pot V,
PERSON COLLECTING SAMPLES SoDM 60)Av-.J
LABORATORY PAte A-4*1,j .ra Lab Cert. #
Comments on sample collection or analysis:
tJ O 61-0 (-r o� 4fIf Lev— 0 Wi A I
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR
I�ED PLEPERIOD
orr [.a-Monthlyl ❑MA D
ec
REGEc4 (month)
APR O J LU jpISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
CENTRAL FILES [90ther C
DWR SECTION
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 ->
to discharge this period2l
Outfall No.
Date
Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended
Solids
pH,
Standard
units
Copper
Lead
-
Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total
Toxic
Organics5
Benchmarks
_
-
100 mg/L or 50 mg/L^
6.0-9.0
0.007 mg/L
0.03 mg/L
0.067 mg/L
15 mg/L
1 mg/L
' 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.
' See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.

I 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).
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for
TTO monitoring may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other
elements listed in the General Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following
certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic
organics (TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which
are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is
implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan."
Name (Print name)
Title (Print title)
(Signat (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, then must be reported in the format, "<XX mg/L", where XX is the numerical
value of the detection limit, reporting 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
text.

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
imprysonment for knowing violations "
Signature of Permittee)
(Date)