NCG030655 DMR SW (4)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG030000
Date submitted .J.44. 4, Zo/7
CERTIFICATE OF COVERAGE NO.NCGO3..d;; -.;s - SAMPLE COLLECTION YEAR 70'(o
ys;: -
FACILITY NAME Ais:aR/c as /Cr6,._a4 7?4,2d.A.G SAMPLE PERIOD 0 Jan June ®July-Dec
COUNTY .44axA4 P'2 or 0 Monthly1 (month)
PERSON COLLECTING SAMPLES Se--�-6 Lti:,S aa.2-M,c.IL DISCHARGING TO CLASS DORW [JHQW 0Trout DPNA
LABORATORY Lab Cert.# E IIV D2ero-flow []Water Supply OSA
Comments on sample collection or analysis: Other
JAN232017
CONTS
PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3
-7 Dim SECTION
Part A:Stormwater Benchmarks and Monitoring Results
0 No discharge this period?2
Date Sample 24 hour rainfall: Nan-Polar O&G/ Total Toxic
Outfall No. S tedi amount, Total Suspended Solids Standardlunits Copper Lead Zinc Total Petroleum 5
(mo/dd/yr) Inches3 Hydrocarbons Organics
Benchmarks-=;> - - 100 mg/L or 50 mg/1.4 6.0—9.0 0.007 mg/L 0.03 mg/I. 0.067 mg/L 15 mg/L 1 mg/L
t .s.%)4 Oct'4 elk:a i7e.o•K) F-ee R ed4P..t R 7 1.,z SR/H -E.
z I2.10&I K. . GS 2L. e.‘.$ i I— 1';24. „a &- "32L 344....
a s.,...A D4 C.?v 474 Pia Li.) roe le PrZe be•kf Aw ve S4 A't.-e.:„.- .f•00/ ..
1 Monthly sampling(instead of semi-annual)must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Z For sampling periods with no discharge at any single outfall,you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on-site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit,Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations,manufacture semiconductors, manufacture electronic
crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent
Guidelines for the facility subject to the requirement to sample(for metal finishing use the definition as found in 40 CFR 433.11;for semiconductor manufacture use
the definition as found in 40 CFR 469.12;for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use
the definition found in 40 CFR 469.31).

"See General Permit text,Table 5,identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: If you report a sample value in excess of the benchmark,you must implement Tier 1,Tier 2,or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
o A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
e 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
O TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑NO❑
IF YES,HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑NO
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
1617 Mail Service Center
Raleigh,North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law,that this document and ail 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 of Permittee) (Date)