HomeMy WebLinkAboutNCG060209 DMR SW (16) Y,
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water ualit General Permit No. NCG060000 s>. o<0 �`..J�
Date submitted — I cam- (e h3� ,,, .‹, a
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CERTIFICATE OF •VERAGGEE Ni NCG06(� O ` SAMPLE COLLECTION YEAR Q 4 ( c �A Q)
FACIOULITY NAME
�' :\ `� %ii 5cW. M 1 k FACILITY ACTIVITIES INCLUDE(check all that apply): '/
❑use/process meats Mise animal fats/byproducts fb
PERSON COLLECTI G SAMPLES IN Os, 2r' & DISCHARGING TO SALTWATERS? DYES ®1x10
LABORATORY Icntl 1'roc)4P, Lab`Cert.# Cl`{-'
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
. Part
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A.Stormwater_ Benchmarks and Monitoring Results Total event rainfall z `f or ❑No discharge this period
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1 Oniyapplies 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 ark 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?El yes 115o (if yes,complete Part B)
Part B:Vehicle Maintenance Area Monitoring Results:only for facilities averaging>55 gal of new motor oil/month.,Sf a�"" �41+.` Firr:r7-i w _ h`• 7- ', '�:O. z W' r rr ;ur _'y ;'I6,. g�":Fr'w_.¢i451D r: .:�+'-,5r G'VW
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r''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.
4See General Permit text,Table 3,Identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SWU-249
Lest Revised:October 1S.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 II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDEIS FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES 21110❑
• IF YES,HAVE YOU CONTACTED THE D Q REGIORI.PfaFICE? ES MN;❑
REGIONAL OFFICE CONTACT NAME: " 149P. \�S"— Wit
;s Si- a. s 5V;ll ort cr ovnl,rr\orAoc'r-c
Mail an ori-inal and one co, o this DMR includin! all"No Ditcher!e"re,arts within 30 da s o recei,t o the lab'results or at end o
• monitoring period in the case.of"No Discharge"reports)to:
Division of Water Quality
Attn: DWQ Central Files
161XMail Service Center
• Raleigh, NC 27699-1612.
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."
l
(Signature of 'ermittee) • (Date)
Additional copies of this form may be downloaded at:htto://roortal.ncdenr.ors/web/wq/ws/su/npdessw#tab-4
SWU 249 Last Revised:October 18,2012
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