NCG060299 DMR SW (4)

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SEM 97AN:NUAL STO'RMV1ii4Y'ER ®IS,CHARC:E MONITORING REPORT
for North.Carolina Division of Water QualityGeneral{Perrn'it No; NCG060,000
Date submitted, O — b23-/,‘" /
'CERTIFICATE OF COVERAGE NO. N0006 d 2 ? SAMPLE,COLLECTION`YEAR t�O/�f?
FACILITY N4 vi E. ®. CL .,6S' 7;l ecCo FACILITY ACTIVITIES'`INCLUDE(check all that apply):
C&1UNIT ___ A ❑ use/processmeats ❑ use animal'fats/byproducts
PERS.N;COLLECTINSSAMPLES / /// (w4. -' i ®ISCFARGIN'G•TO
SALTNATERS? DYES �®
LAA!A':e7RATORY ,oatc/ 2z- ;44 c/rhx b Cert.# 3Y'
PLEASE REME;°: ER TO SIGN ON THE REVERSE -
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1 Only applies to facilities that use/process meats.
i he total precipitation must be recorded using data from an on-siterain.gauge.
3 For sampling periods with no discharge at any outfalls.You must,stili submitthisAischarge 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 perf trm Vehicle Maintenance Activities using;more,thartr-55,gallons=of new motor oil per month? ❑yes no (if yes, complete Part B)
Part tB:Velg e"Mainterraroce„Area;Mon,it,orin Results: onl' ,forr,faciliti
.; „',; w_, r w", .,, ',. • . arr}rzx,,; s .g`,w,,, y.,, es averaging>55,,gal of;new motor oi,fl/month.
� "T,S��'opte*G�ollected sw 4�.j�..;>w011 v�, i�',s°: :;r`ya,. e .,Y%: zit- ,i :',t ,.
ca`s tl^� ea's"e`,t ~TSS' .`.4>``°.;*�°.', ,:
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s Only applies to'facilitiesthat use/proess-`meats.
2The total precipitation must be recorded`-using data from an on-site,,rain.Agauge.
3 For sampling;periods with`no`disehar'g`e at any outfalls;you must stilhsubrnit'this discharge monitoring report with•a checkmark here.
4See General Permit text,Table 3; id'e'ntifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SW>LT-249
Last Revised: October 18.2012

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*FORPA",T 1‘1D-PART'B,MONITORING RESULTS:
0 A BENCHMARK.EXCEEDANCE TRIGGERS`TIE,R'1REQUIREMENTS. SEE-PERMIT PART IISECTION B.
e 2 EXCEC:,DANCES,IN--A•RO JFOR THE SAME PARAMETER AT THESAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
e TIER 3: -HAS YOUR-,FACILITY HAD 4 OR MORE-BENCHMARK;EXCEEDENCES-FORTHE SAME PARAMETER AT ANYONE OUTFALL? YES El NO
OF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
1!%Fall-[•;naoriiinal-anttat*vopy.of=this4DMROnc/udinq.$all.;"Nthatiehar. e".re 'f i d ' ",`,,t '
•; il �ri �:p'ea°�od:=in tlie',ease o ��., ;
g por �v`i�thir°�3©.�days�of�,re�eipt��of-th'e��labxresults dor r.t end of
,_ f No;Discharge, repo 'ts)to:
Division of Water Quality•
,Attn: DWQ,Cen.tral Files
1617•MaiVSe.rvice-Center • ' `
Raleigh;,N,C=27699-1617
YOU MUST SIGN,THIS=cERTIFLC'ATION,FOR.ANY'INEORMATIONREPORTED•
°1 certify, under penalty of Iaw;,that this docurnentand all attachments-were,prepared-under.my-direction-or supervision in accordance with a
systei designed.to assure that qualified-personnel,properly�gather��and,evaluate-thedinform�ation submitted. Based'on'my,inquiry of the
person•or persons who;manage.the;system,or.1thosejpersons directly responsible-lotatl eri;ngtheei,nfo'rmation,the'inform•ationrs'ub'mitted is,
to the best -f my',knowledge:and belief, true, accurate, and,compl,ete. I am,-aware::that==there:are significa'tnt'penalties for submitting false
information,,,including,.t'Fie-possibility-of fines=andimprisonment for-knowing violations: -
44;1 ,11—/‘
((Signaltur ,o f Permittee), )_,
' �D�ate ,
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/webtwq/ws/su/npdessw#tab-4
(7):— •
SWU-249 �` Last Revised: October 18,2