NCG060158_MONITORING INFO_20171028

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V
DOC TYPE
❑HISTORICAL FILE
X� MONITORING REPORTS
DOC DATE
❑ i- 0 "1 (0l8
YYYYMMDD

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted r1 6, RECEIVED
CERTIFICATE OF COVERAGE NO. NCG06 O t S g
FACILITY NAME _ &o dvod A& 11C FLLC r
COUNTY l"o�tM /lau _
PERSON COLLECTING SAMPLES
LABORATORY 5'Fmks,,.N� Ar_,dwt� Lab Cert. # NC_ It44.o
EPA nNC.00%q
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2-o+ ~7 OCT 2 6 2017
FACILITY ACTIVITIES INCLUDE (check all that apply): CENTRAL FILES
❑ use/process meats ❑ use animal fats/byprotM SECTION
DISCHARGING TO SALTWATERS7 ❑YES gjNO
PLEASE REMEMBER TO SIGN ON THE REVERSE -)
Total event rainfall Z 1 •S « or ❑ No discharge this period'
Outfall.,No.
Sample: Collected,
mo/dd/ `r
TSS; -
m /L -..
. pH, ..
standard units
D
COD, ;.,
m L
,.. oil,and Grease,
::.
mg/L
Fecal Colifnrm ;
Colonies per 100 ml ..
Enterococci , ,
Colonies, er 100 ml
Benchmark
_
`100 or40
Within 6A'9.'0 r
'­120'
36
l000
50o
1 Only applies to facilities that use/process meats.
The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any 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 oil per month? ❑ yes Erno
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
` Outfall No:
Sample Collected, '
�, mo/dd/yr
< "Oil Grease;
°, ingJL
TSS,
mg%L
pH,
Standard units.
New Motor Oil Usage,
Arinual'average gol/nio'
Benchmark
-
30
100 or 50
6.0 — 9.0
-
Only applies to facilities that use/process meats.
ZThe total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any 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.
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Paac 1 of

*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 a.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NOD
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 for at end of
monitoring period In the case of "No Dischar e" reports) to. -
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 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 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."
re of Permittee)
(Date]
Additional copies of this form may be downloaded at: http://PorLal.ncdenr.or web/wg/ws/su/npdesswtttab=4
S W U-249
Last Revised: October 18, 2012
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