NCG060209 DMR SW (21)

SEMI-ANNUAL STORMWATER DISCHARGE MONITORINGPORT 4•
for Norah Carolina Division of Water kuality General Permit No. NCG060000 qc6'Rie
Date submitted P—1 Ley4"i1 4/8
CERTIFICATE OF C VERAGE NO.NCGO6aL. MI SAMPLE COLLECTION YEAR off.Q)
FACILITY NAME -C6� FACILITY ACTIVITIES INCLUDE(check all that apply):COUNTY uQ 0 use/process meats Dime anim�a.�l,f�a /byproducts
PERSON COLLECTING SAMPLES • DISCHARGING TO SALTWATERS? OYES IJO
LABORATORY Lab Cert.#
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part Ai
b�-•e,17:,-d,%t'gjb�ll+,-. Sl}tLrI opryr'�+3m:.•£ wal'te•2'rr Benchmarks
enchmarks and
d Monitorin,4[g{;Results
esults- ...,r •..{- i,i . _. iTotal
otal event rainfall 2 or It
No discharge
ischarge this pe
ro
d
'r
8 k1_�y �"( Igzir � }R � VPN� �F��� 1rr�.f ��M �Tl�PF Ad� M�" �f1d:t :�".tis! � ig 1.naffiil 43: el � fNIF � � Y � a: � t � i Nr t,1 i4
1
+ Yte _iQ,irr ' Yr. 11? I11i r °M1UF ` iiNcerp_J7y-m
•
•
zOnlyapplles to facilities that use/process meats. 1\1 r O # ,/� A/O �(��� , A
The total precipitation must be recorded using data from an on-site rain gauge. (v V
aFor sampling periods with no discharge at 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 ail per month?❑yes 0 no (if ves•complete Part B)
Part
art B:Vehictlel Ma
ifintt.tenanclelAre
a M�?otfn�,it oring Results:
onl for facilities
acilities a
v)4ete.ra'_��gin1vgY�f.1a 5F3.5 gal
.AyI:-o. f new
ew m
o.h.;"t+{oo.1iytr t1oll/�1•i m�.lo-��n,��th1��.
�Ar-;-,C-N1105
$ �rqIv��. r• ���iy - '�1� -
t• ��`
7 i �tl tp �{t� =. �1 qpi f•NrC,nt0i ,Apr �t styitti7F1154n� ; GA ,rf4 .1 .^••; =� .V Y rntekWSY s � �R §lr , PS� : EMI IMAE•
•
Only applies to facilities that use/process meats.
The total precipitation must be recorded usi
g data from an on-alta rain gauge,
•or sampling periods with no discharge at 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.
3WU-249

*FOR PART A AND PART B MONITORING RESULTS:
o 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 SECT oN B.
▪ TIER 3: HAS YOUR OUR FACILITY.HAD 4 OR MORE BENCHMARK EXCEEDENC -FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ( NO❑
U CONTACTED THE
REGIONAL OFFICEO CONTACT NAME:DUQG;�NAE.\ ICF.Y, <1[ � NP
�_____r..__..e..rs,.s il.e I,yLr raCulls/Ar at end Of
Mall an original and one copv�of this DMR,including all"No Dlscharae"reports, within Su days of receipt th
' monitoring period in the case.of"No Discharge"reports)to:
Division of Water Quality
Attn: DWQ Central Files
• 167d1Mall Service Center
• Raleigh, NC 27699-1613`
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."
(Signature o Permittee) • (Date)
•
Additional copies of this form may WI downloaded at: tt•: .0 a . c•e o : we. • ws su i •dessw• . ..di
Last Revised:October 18,2012
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