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SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT RECEIVED
for North Carolina Division of Water Quality General Permit No. NCG060000
'Dat'esubmitted 1)e.re �P \4�2D15 -7`• • DEC 2 2 2015
_ CENTRAL FILES
CERTIFICATE OF COVERAGE NO. NCG061 ' 5_ SAMPLE COLLECTION YEAR I�1,`� DNR SECTION
FACILITY NAME ��aol Niviq', at�r�,... ream FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY(�a\(en ❑ use/protess meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES hict1eA.e. 7 to Nl DISCHARGING TO SALTWATERS? DYES CRINO
LABORATORY L v(c�ern 'c\ a.,, Lab Cert. # 1
PLEASE REMEMBER TO SIGN ON THE REVERSE -
Part A: Stormwater Benchmarks and Monitoring-Results . . _ , c _,_ , .• J _ Total event rainfall 21(11A o,r n No discharge this period3
," •'' :r ::4.-14-:00k../.01;4;_, .; 5;' t O .' '�'-— pi l.a'n'11t,i:ease' °r':;EtecatColifo`rri'i," . :,t..>k'a:Enterococcil,:-,.{.r
.Outfall,No: �-SarripletCollected,;: ;-{frTSS:-r���:'� r�.,=,..°�np,�r+,,,.�f�';;s� . !�?�.T.,�n L.� ., F--__•�.:�.. :,Er•:_ �•, ,. _�...��..•����r"_n.,a`.
_ - �a. _ �•f. �cw ;,xty.;;c r .. i �v:,,4,,,,Y...'`r: f �%�t:�r'ii`:s�::a%.:.>t.-ti.:r�$•- a�, •Pr . .a ,rSi a-z.. � ��,�T+ � S-
1=;' `«..r" t7... -,. >• r<r r= r: r-i `,",••.; •Colonies e1: 00'mli.,• C'06-nies'pery100fm1' :
. � ,,,._ _- mo%d`d/Yr-��_y. ,;tr�mg/��z'-�_,��<iStandardnunit"s�,����x::mg/.1-�«::�:�.�.:-�.-,:�.,. mg/.4;a;-.•:..�,.<.c p..., �+•
• - .tt:. 4._ <`'.: .i1' i ",.t';:�^•- -17- i�tk•,;.....��; .{S:,i.Ceti-i°`y:.at•�,-r-.t°4"-:; -1?: .:.'�••1:=;` "`_r '•50riv.:_''`.r`'� ,-
Benchmark:. .:::-,f-',-.1,'„-_-_-`1,5-:��100'or�50: .WithiW6,0`_a 9;0s x. :.120 „ ;��.� �r:30 ;�:. _
.$�1. I t/Ick/15 9.'1 .- . .. -1.2 _ • , 't <- 2'0 . 4 5
1 Only applies to facilities that use/process meats. '
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.
'See 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? n yes 114 no (if yes, complete Part B)
Part B: Vehicle Maintenance Area Monitoring•Results only for'facilities averaging>_55 gal o_f new motor oil/month.
✓i+ vr.5-,r;rr: `'g .r:. r:��y.'- '1�.=„:r''r:J2 s h.t].'"�=": t,.•,:.-.,,,, ,,µ{1 . .»s c:'u ,:s�sa •
•`Outfall�No: `Sam Ie=Collectd,���:�"_ ;50II�an`d�Grease;:��� ;�._,;=�t���,r_T53����,��,•c,.,� �,_;�:.;n��ipH;•-' .�3s.�-4= New,IVlotot;Oil�U'sage,,,
I? yrc:.arts c� �Cr' r..: �w .�4 �a`2`�5 + : °T dol ;.�<;..: Z id =,sF' -
_ _ r,',^'?�:�: Wit:r�°'�,*�r;;,, .r" :�:„•` ib,..;rt' � ,r: ;.1-. c., gy.,, A - _..
. . . s i'a=mo%dd%yrr` ^�-i°-6 r,-;x: :;mg/L tt 4-A•: ,, ,,, :cm I,e;g-,�,2,; Standardunits• ;F IAnnual�avera e, al'mb
- iJ .1 igii1 Qr ' •�. 1 :a. i ,✓1•. +,2%,.:”. •1',; :tT:j••C
X30,;= .c: •: 50+ `'6:0:-9.On.,_
Benchmark- -, _, -„ ,-,--;/;`,1J- ::}�;:.:�:. � .,..,-•.r,= ��r� ;._100;oc_ ry�.�«_tii ,.:�:;- _ . .._ _ ---K
- :' • - . •,, : -
' :�. - . . -
1 Only applies to facilities,that use/process-meats. _ -
2The total precipitation must be recorded using data fro"ni an bn=site'Airi gauge. . ` `
3 For sampling periods with no•'diEliarge of 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':
• A BENCHMARK EXCEEDANCE TRIGGERS TIEFe1 RECZl71•REMEfVTS. 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 II SECTION B.
* TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK-EXCEEDENCES;FORTHE SAME PARAMETER AT ANY ONE OUTFALL? YES n NO �J
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? -YES-Q-NO'X '
REGIONAL OFFICE CONTACT NAME: -
...Vi:•.µ .- ._. •_�...�. .,,
Mail•an oriqinal and.oiie�cop`y_of_this:'DMR ncludinq allflilo_Discharge"repor,'ts;�•Qv,tfiiny30 days ofire'ceipt*df tJie-lab-results (or at end of
,-..' •.- r --i7'r;u• thi.�,' :}�}} to=�L'�`"...�it Z, � ,t;r+yr,.1�r"r-;, •}'•
monitoring period`in the'case of"P d Discharge rrepo`rts1�to,`�i•'`" a ',� '• o�•lir:` '`a'�`i'r`
, ' .P.Itc, rl ,_ n -}, •. _ 'i - . .1r• • :, l :.! •
"I„ q,ig.tsion-PDIVafg1�.-RYalitYs• I. . IA ;, ' • •
_ ;, • 'Attn: DW,g,(Pnxl:alt-Eil-es:�-_ t • . • :r ,
1517-1 ail:Ser-viee Center-.
YOU MUST SIGN_THIS-CER.TIF_ICA,TION EOR_A_NY_•1NEORMATION-REPORTED:,��__-•___ •___
"I certify; under penalty-of law,,thiait-t�hias-do; cfuments•Tan:d.allatachrneritswee-prepar.ed_undermy_direction.or supdr_vision in_accordance,cordance,w
ith a
n,u4' ,
system designed to assure-th-dt;g ,alfied p. rsorjetliprgpr]ygat• err,and:evaJatQ:t :informatio. • ubmittie .- Based-on-my.inquir_y"of-the 2U; OD WILV -
•
person or persons w •mana e thes ste , ooe� esQis=d)retres ori bleifo a eripgthefoig tionthe inforinatipn-supmitted is,
to the best of my knowledge and belief;true ;ac u a e,and compl' te: I�am aware f%i t tj'e�ea eslgn ficantpenalties for submitting-false
information, including the possibility of-fines and imprisonrnent for knowing Violations."
L• 'fil.07 iji / _ .r• .,. =1/O./NM-IA/rT' ��/�' •
(Sjinature of Permittee) - '(D"at" t• -' 4,
•
Additional copies of this form may be downloaded at: http://bortal:ncdenr.orR/web/wq/ws/su/npdessw#tab-4
•' ' "'q •��' 'jS"i;^l1' .�t_ e.4.,��f, r' RS• 'olio a..4. r,lrrf't 'S
SWU-249 Last Revised: October 18,2012