NCG060026 DMR SW (3)

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RECEIVED-
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT JUN 3 0 2016
for North Carolina Division of Water Quality,General Permit No. NCG060000 DEiNR-LAND QUALfTY
' Date submitted 0'-'a --I r' STORMWATER PERMITTING
CERTIFICATE OF C VERAGE NO. NCGO6 () _o - SAMPLE COLLECTION YEAR o� a 16
FACILITY NAME C°\oNit �`\ �( • FACILITY ACTIVITIES INCLUDE(check all that apply):
COUNTY O s .` . 0 use/process meats arse animal r is/byproducts
PERSON COLLECTING S! P ES % \n lADISCHARGING TO SALTWATERS? DYES L' O
LABORATORY V1.1-o e`t \ , Lab Cert.# Q14"
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A:_Stor_mwater Benchmarks and Monitoring Results Total event rainfall 2 C.Co'or 0 No discharge this period3
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i Onlyapplies 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 g 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?D yes (gym,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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'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 an,(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
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*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 SE TION P
▪ TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES [ NO
IF YES,HAVE YOU CONTACTED THE DWACI.RGI NAL OFFICE? YES ❑ NO[kr
REGIONAL OFFICE CONTACT NAME: NI 1 c c \ tc- + -‘ttrZ54244
Mail an oriaiinal and one copy of this DMR,includina all"No Discharae"reports, within 30 days of receipt of the lab'results(or at end of
monitoring Period In the case of"No Discharae"reports)to:
Division of Water Quality
Attn:DWQ Central Files
• 161aMail 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 ines and imprisonment for knowing violations."
(Signature of Permittee) (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/waiws/su/npdesswittab-4
SWL7 249 Last Revised:October 18,2012
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