NCG060209 DMR SW (17)

SEMI—ANNUAL STORMWATER DISCHARGE MONITORING REPORT RECEIVED.
for North Carolina Division of Water QualityGeneral Permit No. NCG060000 JUL 0 6 2015
Date submitted --A- AS
CENTRAL FILES
CERTIFICATE OFC VERGE NO NCGO6��•�-r''`°' �� DN/R SECTION
�R y ��"..�'� n 1 SAMPLE COLLECTION YEAR � i=
FACILITY NAME \\\trc��' — ()�,1n .Sc•W � J‘\\`\ FACILITY ACTIVITIES INCLUDE(check II that apply):
COUNTY Z.) y1)V(1 ❑use/process meats se animal f_a�t /byproducts
PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERS? DYES
LSU
LABORATORY Lab Cert.#
PLEASE REMEMBER TO SIGN ON THE REVERSE 3
Part Ai Stormwater Benchmarks and Monitoring Results Total event rainfall 2 or No discharge this period3
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1 Onlyapplies to facilities that use/process meats. � �- `J � \
2The total precipitation must be recorded using data from an on-site rain gauge. 1\ N
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?❑yes ❑no (if ves,complete Part B)
Part B:Vehicle Maintenance Area Monitoring Results:only for facilities averaging>55 gal of new motor oil/month.
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1 Only applies to facilities that use/process meats.
:The total precipitation must be recorded using data from an on-site rain gauge.
For sampling periods with no discharge at my 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

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK E'XCEEDANCE 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 5 TION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENC S FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES [ NOIF YES, ❑
REGIONAL OFFICE CONTACT NAME:E YOU CONTACTED THE D R N, 4Q��� 1(ES� NO[�
s � s s\‘:\\ (yr,
Mail an original and one copy of this DMR,including all"No Discharge"reports, within 30 days of receipt of the lab results(or at end of
monitoring period in the case of"No Discharge"reports)to:
Division of Water Quality
Attn: DWQ Central Files
• 161oZMail 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."
� - 1- / s
(Signature of Perini tee) (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-249 Last Revised:October 18,2012
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