NCG060282 DMR SW (4)

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT -
for North Carolina Division of Water guality General Permit No. NCG060000 RECEIVED
Date submitted ", 6"1t-S"
CERTIFICATE OF COV RA E ©.'a CGO6 - % SAMPLE COLLECTION YEAR G5 01 '
SEP 01 2015
FACILITY NAME o
• 0 • f J s\\ FACILITY ACTIVITIES INCLUDE(check all that apply): CENTRAL FILES
COUNTY • • --_-. O use/process meats se animal fats/byproducts �WR sECTlOfii
PERSON COLLECTING SAMPLES; • \\e-— *_ DISCHARGING TO SALTWATERS? OYES ENO--
LABORATORY - L. \'„ Lab Cert:--14.).(-) 1
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
/1)
Part Ai Stormwater Benchmarks and Monitoring Results
R4F
" Total
otal efvyei n.at rainfall 2 I or 0 No
discharge this p
eria'
o
d
'
j!--;1.:41-001705.5 a�: � frat47vF. lLY � X;.i2fi � f i '� � f; II
v� � �fr q j ;iiw1f_
-` rxgY.w:se;,di T }teg 1 _�Sl1� R• ,Z 3;' - � � , i � ,: -,l �4,� ic, lM�� .trs:r.c.k �!��.f ,�r.�rM6 �.y ,$ :� C�� � �ei .� " , 9J3 . -
10:: ?�-0 e.49:ffMr { ryf!ra}T � a� �y7� , � - urR iya�Va �-rttiIfti Stvi _ ,b
% • 8— --r. - «k r1x40 ci). C le-*ZZ L A/A /VA
1 Onlyapplies to facilities that use/process meats. \
2The total precipitation must be recorded using data from an on-site rain gauge.
-nC�OI� �� �� I i
rn\�`
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?Ees 0 no (fits,complete Part B)
Part B:Vehicle Maintenance Area Monitoring Results:only for facilities averaging>55 gal of new motor
oil/month. 4 ( tsctit,Ou
d-
; or17tT`RFt pgrgn •U�ye a$ tiAIA� � ^ �
;
•
1 t�ll yrj "i 1 � mbi� A�� 0. �/ ateda y� _za �� + ociViz� fitt4- _ 4nT ��a kft. Yo � 0.
Bp•ghltnv,mig Ws _ -'0 s11ISLU } LL N mentr t.i1t ; isP SN:I M: sa_ t1 . oc\\. or 0 4i- GI ,
1 Only applies to facilities that use/process meats.
ZThe total precipitation must be recorded using data from an on-site rain gauge.
:The
sampling periods with no discharge at anv 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 II SECTION
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑NO I'
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO D
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(or at end of
monitoring period in the case of"No Discharge"reports)to:
•
Division of Water Quality
Attn: DWQ Central Files
161aMail 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."
my/
(Signature of Pe 4. (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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