NCG060209 DMR SW (13)

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted , � • x — ( C
CERTIFICATE OFC VER GE NO. 4C606 0\ O I SAMPLE COLLECTION YEAR OW C
FACILITY NAME FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY n ❑ use/process meats n use animal fats/byproducts
PERSON COLLECTIN6 SAMPLES DISCHARGING TO SALTWATERS? AYES D90—
LABORATORY Lab Cert. #
Part A: Stormwater Benchmarks and Mnnitnrine oee..i.m
PLEASE REMEMBER TO SIGN ON THE REVERSE 3
n -- —s_ .-_r_-u i - rri
,��
��
Z
— -- -- • -o • —
�;�
i vLwi event rainjan
2�.a
orvo atscnarge rnis perioa
" Y
IS ,d'K 3`:.�,"r�c��.l��1�.� 1.. �
Y,t � lh�F� i�.�n� ` C- -�
7u' •;% A ti'r
� ;�h, ` 5?
''�''- i
J O� �
y��'�
_
I
I Y
4� . Yli
e•1 R,
s
-
t1niv ann11C1c +n f-111+1n� +1, .+ .....
—.1 -1'.. - ................-:� r.— wcj N1 uL.CaS Ine'at-Mmc
115. c
The 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.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than SS gallons of new motor oil per month? ❑ yes ❑ no
Part B: Vehicle Maintenance Area Moniterina Recites nni.. fnr �,., i 9 11! 11!
N' - r -
i" F-.
aAA%1pI ��f�`+l`I' j1 l fin : b_� nl f 3rdp4'i r n, 1r 3 ` )°]II2�eL,Cit,.11�i�1�� ^�{� t.,, �4.jP,''I� q9 �7r;4 L
r E1 1� /�) ) f - , I1 'LL? Y S 1 -` 'i"�1F.-��
` 4 a �. ❑ 6 A ,,- f ''1'aJi��Lv-�dYo. n? Fl 1L' `a i��f�sl3 1 kj�
f - .A�..�u I}v..: •!}1'.(•� M.
E^�N yc.
ra'+�.1','.�,:uN �' ��
s
-
_.eY ..L.r..�� ....o..,...ICJ L110L use�proCe55 meats.
ZThtotal precipitation must be recorded using data from an on-site rain gauge.
s 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.
�E- C,E
U � 07 2016
(i ` ei l comp ete� ��al • ANG
J'
SWU-249
r ..... n,...t....a. A..r..Re.. 14 7M 7

`FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II�TION B.
• TIER 3: HAS YOUR FACILITY. HAD 4 OR MORE BENCHMARK EXCEEDEN 5 FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES NO ❑
IF YES, HAVE YOU CONTACTED THE D \Q EGIO A QFFICE?S ( O ❑
REGIONAL OFFICE CONTACT NAME:�°� M`61r� 1
Mail an orlainal and one coav of this DMR, includin all "No Dlscharae" reports, within 30 days of receipt of the lab results !or at end of
monitorina perlod in the case. of "No Discharaef reoortsl to:
Division of Water Quality
Attn: DWQ Central Files
161AMail Service Center
Raleigh, NC 27699-161
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
�-(-�g
(Date)
Additional copies of this form may be downloaded at: http://partal.ncdenr.ors/web/wa/ws/su/nt)dessw#tab-4
SWU-249
Last Revised: October 18, 2012
Page 2 of 2 .,