NCG060279 DMR SW (2)

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT RECEIVED
for North Carolina Division of Water Quality General Permit No. NCG060000 APR 2 ® 2015
Date submitted — 8 — IS CEN -F[. -,,AL FILES
CERTIFICATE OF CO ERAGE NO. SAMPLE COLLECTION YEAR S ©WR SECTION
FACILITY NAME o5 FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY -'-t> u ; r-, -- -_ ❑ use/process meats [fuse animal fats/byproducts
PERSON COLLECTINIG SAMPLES UC ' - DISCHARGING TO SALTWATERS? []YES 200
LABORATORYLa ert.4,
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
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Total event rainfall 2 f • S or ❑ No discharge this period3
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unlyapplies 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.
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 55 gallons of new motor oil per month? yes ❑ no (if ves• complete Part B)
Part B: Vehicle Maintenance Area Monitoring; Results: oniv for facilities averaging > 55 gal of new motor oil/month
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unjy 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.
4See 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

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES F-1NO V
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, includina all "No Discharge" reports, within 30 days of receipt of the lab. results for at end of
monitorina period in the case of "No Discharae" reports) to:
Division of Water Quality
Attn: DWQ Central Files
16U,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, including the possibility of fines and imprisonment for knowing violations."
(Signature of
q -1--(S
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.ore/web/wa/ws/su/nodessw#tab-4
SWU-249
Last Revised: October 18, 2012
Page 2, of 2 vy

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SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT APR 2 0 2015
for North Carolina Division of Water Quality General Permit No. NCG060000 CEN i RAL FILES
Date submitted I-V— S ` IS
DIAIR SECTION
CERTIFICATE OF COVERAGE NON 0,06' SAMPLE COLLECTION YEAR 05 O
C6�.T y S
FACILITY NAME ' ` -- I> FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY ❑ use/process meats use animal fats/byproducts
PERSON COLLECTING SAMPLES ca CIC SCIA DISCHARGING TO SALTWATERS? ❑YES EWO
LABORATORY Lab Cert. #
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A, Stormwater Benchmarks and Monitorine Results Tntnl avant rninfnll 2 4/7 nr M A:n na.-:.,113
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2The 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 S5 gallons of new motor all per month? ❑ yes g3'h155" (if yes • complete Part B)
Part B: Vehicle Maintenance Area Monitorine Results: oniv for facilities avaraaina �t, SS ani of notat rnn+nr nil lmnn+h
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3The 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.
SWU-249
Last Revised: October 18, 2012

*FOR PART A AND PART B MONITORING RESULTS:
• 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 If SE ION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDEN FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES (ZNO ❑
IF YES, HAVE YOU CONTACTED THE D Q REGIONnT's
4FICE? Y S 0N ❑
Im
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 for at end of
monitoring Qe*d in the case of "No Discharae" reports) to:
Division of Water Quality
Attn: DWQ Central Files
16V, Mail Service Center
Raleigh, NC 27699-16177,
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
- `- (IS -
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.ors/web/wa/ws/su/npdessw#tab-4
SVM -249
Last Revised: October 18, 2012
Page 2 of 2