NCG030500 DMR SW (5)

ST .
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quali y General Permit No. NCG030000
Date submitted /2/(5 /fr
CERTIFICATE OF COVERAGE NO. NCGO3 b 5 0 0 SAMPLE COLLECTION YEAR ,20/�
FACILITY NAM GC tear'," — SAMPLE PERIOD Jan-June ®July-Dec
COUNTY / Ader c aor JJ I�
PERSON COLLECTING SAMPLES e� F7dye, DISCHARGING TOJCLASS EIJOthly' (month)
LABORATORY TZ-37-�,-,'�� Lab Cert.# 7�oeJ ❑ORW []HQW OTrout �PNA
Comments on sample collection or analysis: RECEIVED OOtheflow Water Supply �SA
DEC 9 2016 bother C ss'-�
CENTRAL I✓PLL tSE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
Part A:Stormwater Benchmarks and Monitoring Results DWR SECTION
❑No discharge this period??
Outfall No. Date Sample 24-hour rainfall Non-Polar O&G/
Collected' amount, Total Suspended Solids and Copper Lead Total Toxic
Standard units Zinc Total Petroleum
(mo/dd/yr) Inches3 Organics
Benchmarks===> Hydrocarbons
- 100 mg/L or 50 mg/L4 6.0-9.0 0.007 mg/L 0.033 mg/L 0.067 mg/L 15 mg/L 1 mg/L
D4--not. r'/ q//ile C. / " P,,��*
les 7D 46,1)&5 „ ezo39 ..®z4, .0 2-4,1 e2.0
' Monthly sampling(instead of semi-annual)must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall,you must still submit this discharge monitoring report with a checkmark here.
'The 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.
'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).
Permit Date• 11/1/2012-10/31/2017
SWU-245,last revised 10/25/2012
, Page 1 of 3

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Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TfO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver,the discharger shall sign the following certification statement.
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TfO), I certify that to the best of my knowledge and belief,no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan "
PI OD M> eT/l
Name(Print name)
P -4TM /\1 �
Tit Pn t title)
(Signature) (Date)
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL,<PQL, Non-detect, ND, or other similar non-numerical
format. When results are below the applicable limits,they must be reported in the format,"<XX mg/L",where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
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.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging> 55 gal of new oil per month.
H No discharge this period?`
Outfall No. Date Sample 24-hour rainfall
Collected) amount, Non-polar O&G/TPH by Total Suspended Solids pH
(mo/dd/yr) Inches3 EPA 1664(SGT-HEM)
Benchmarks=__> - - 15 mg/L 100 mg/L or 50 mg/L* 6.0—9.0 SU
Footnotes from Part A also apply to this Part B
*See General Permit text,Table 5,identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Permit Date: 11/1/2012-10/31/2017 SWU-245,last revised 10/25/2012
°age 2 of 3

lik
117)
No e: 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:
• 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 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑NO El
IF YES,HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES []NO 0
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 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 per •• directly responsible for gathering the information,the information submitted is,to the best of my knowledge and belief,true,accurate,and complete. I
am aw there are significante
penalties7r r sub 'tting false information,including the possibility of fines and imprisonment for knowingviolations."
/4 s.(Signature of Permittee) e) ���j�
(Date)
Permit Date:11/1/2012-10/31/2017
SWU-245,last revised 10/25/2012
Page 3 of 3