HomeMy WebLinkAboutNCG060209 DMR SW (18) RECEivED
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT AUG 2 9 2016
for North Carolina Division of Water Quality General Permit No. NCGOGOODO DSR_
Date submitted CI--' as" J STp-w . CAn+n ^',l',J .
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CERTIFICATE OF COVERAGE NO.N0006%'%.O °'1 SAMPLE COLLECTION YEAR ao 1
FACILITY NAME V , . - b • A A 0C5o, -e k\‘ FACILITY ACTIVITIES INCLUDE(check all that apply):
COUNTY Z) + ` ❑use/process meats Mime anim,�al.,f�a s/byproducts
PERSON COLLECT G SAMPLES n a " S 51
DISCHARGING TO SALTWATERS? OYES 0
LABORATORY v1Cae Lab Cert.# (-Nk
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A:Stormwatter Benchmarks and Monitoring Results Total event ml all Z I
or • No discharge this period3
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'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 gay 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.
lid this facility perform Vehicle Maintenance Activities,using more than 55 gallons of new motor oil per month?El yes Vo (fes complete Part B)
art B:Vehicle Maintenance Area Monitoring Results:only for facilities avera.In >55 i al of new motor oil/month.
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. • 1
)nly applies to facilities that use/process meats.
be total preclpitatlon must be recorded using data from an on-slte rain gauge,
Oor sampling periods with no discharge at gag outfalls,you must still submit this discharge monitoring report with a checkmark here.
ea General Permit text,Table 3,Identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
NU-249 .__.....--.1--A.r+....a,.--1 0 .1111 e
*FOR PART A AND PART B MONITORING RESULTS:
e A BENCHMARK EXCEEDANCE TRIGGERS TIER 9.REQUIREMENTS. SEE PERMIT PART II SECTION B.
O TER 3: A HAS YOUR IN A FACILITY.FOR THE SAME MOREPARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT BENCHMARK EXCEEDEN ES FOR THE SAME PARAMETER AT NY ONE OUTFALL?PART YES"IJ NO❑B
• TIER 3: HAD 4 OR�( ` 1��
•
IF YES,HAVE YOUCCONTACT NAME:CONTACTED THE �R �N""`\.\\S'� W �'MNO
REGIONAL OFF `1 1
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StS-\\ Ori cror��\, (rbo;koNc\�1
Mall an o l,in&and o eco- ,o this DMR,:i cl n!. all"N ► `sc r:e" ,arts : It In 30 da s o recei-t o`the lab rests is or at endo'
monitoring period In'the case.of"No Dlscharae"reports)to:
• Division of Water Quality
Attn: DWQ Central Files
16W.Mail Service Center
• Raleigh, NC 27699-161X.
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:,
" certify, under penalty of law,that this document and all attachments were prepared under my direction or ed supervision in
accordance
inquiry of cee with a
I on my
system designed to assure that qualified personnel properly gather and evaluate the information submitted.
e
person or persons who manage the system,or those persons directly responsible for gathering teiform significant io nalhieinformationfor
submitsubmitted is,
to the best of my knowledge and belief,true,accurate, and complete. I am aware that
there areinformation, including the possibility of fines and imprisonment for knowing violations."
g -0767-/6"
Signature of Per ttee) • (Date)
Additional copies of this form may be downloaded at: tt•: ;�o - .1c.e, o e ws s i •essw i •-4
Last Revised:October 18,2012
SWU-249 Page 2.of 2 .,