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HomeMy WebLinkAboutNCG080624_MONITORING INFO_20190503STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. /V DOC TYPE ❑HISTORICAL FILE MONITORING REPORTS DOC DATE ❑ �,O I �Oim YYYYMMDD Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted 4 30 19 CERTIFICATE OF COVERAGE NO. NCGO80624 FACILITY NAME. FedEx Freight, Inc. - CLT r COUNTY Mecklenburg PERSON COLLECTING SAMPLES Barney Smith LABORATORY PAR Laboratories Lab Cert. # 20 Comments on sample collection or analysis: SAMPLE COLLECTION YEAR Z019 SAMPLE PERIOD ® Jan -June ❑ July -Dec or ❑ Monthly'_ (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA ❑Zero -flow ❑Water Supply ❑SA ®Other C PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? X yes _no (If yes, report your analytical results in the table immediately below) Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable) ❑ No discharge this periods Outfall - No. - _ - - - - - Date • ' Sample Collected, mo/dd/yr 00530 00400 00556 Total Suspended Solids, mg/L pH, Standard units Non -Polar Oil and Grease/TPH EPA Method 1664 (SGT-HEM), mg/L New Motor Oil Usage, Annual average gal/mo Benchmark - 50'or 100 see permit Within 6.0 — 9.0 15 - 001 04/05/19 51 7.0 <7.4 600 gal/month Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) _ Outfall No. Date Sample Collected; mo/dd/yr 00556 00530 00400 Non -Polar Oil and Grease/TPH EPA Method 1664, (SGT-HEM), mg/L Total Suspended Solids, mg/L pH, Standard units Permit Limit - 15 50 or 100 see permit 6.0 — 9.0 I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 5WU-250 last revised April 11, 20t3 Page 1 42 STORM EVENT CHARACTERISTICS: Date 4 5 19 (first event sampled) Total Event Precipitation (inches): 0.75 Date (list each additional event sampled this reporting period and rainfall amount) Total Event Precipitation (inches): 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: • 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 ❑ 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 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 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_e significant penaltles for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdesswtttab-4 S WU-250 last revised April 1 1, 2013 Paiye 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted 5/ z 0 8 CERTIFICATE OF COVERAGE NO. NCGO80624 FACILITY NAME FeclEx Freieht. Inc. - CLT COUNTY Mecklenbur PERSON COLLECTING SAMPLES Barney Smith LABORATORY PAR Laboratories Lab Cert. # 20 Comments on sample collection or analysis: SAMPLE COLLECTION YEAR 2018 RECSA❑MPLEiP.ERiOD ® Jan -June ❑ July -Dec or ❑ Monthly' (month) MAY cOS-CAMING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA CENTRAL 1=ILE3 ❑Zero -flaw ❑Water Supply [:]SA DWR SECTION ®Other C PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? X yes _no (If yes, report your analytical results in the table immediately below) Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable) ❑ No discharge this period' Outfall No. Date Sample Collected, mo/dd/yr 00530 00400 00556 Total Suspended Solids, mg/L pH, Standard units Non -Polar Oil and Grease/TPH EPA Method 1664 (SGT-HEM), mg/L New Motor Oil Usage, Annual average gal/mo Benchmark - 50 or 100 see permit Within 6.0 — 9.0 15 - 001 4/24/18 <5 7.0 <6.0 600 gal/month Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) Outfall No. Date Sample Collected, mo/dd/yr 00556 00530 00400 Non -Polar Oil and Grease/TPH EPA Method 1664 (SGT-HEM), mg/L Total Suspended Solids, mg/L pH, Standard units Permit Limit - 15 50 or 100 see permit 6.0 -- 9.0 1 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-250 last revised April 11, 2013 Pace] of 2 STORM EVENT CHARACTERISTICS: Date 4 24 18 (first event sampled) Total Event Precipitation (inches): 1.50 Date (list each additional event sampled this reporting period and rainfall amount) Total Event Precipitation (inches): Note: If you report a somple 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 If 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 ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an oriainal and one copy of this DMR, includina all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitorina 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 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 ific t pe alt' s for submitting false information, including the possibility of fines and imprisonment for knowing violations." 7 519/1W/9 re of Permittee) ( Date) Additional copies of this form may be downloaded at: http://Mortal.ncdenr.org/weblwglws/su/npdessw#tab-4 SWU-250 last revised April 11, 2013 Page 2 of 2 BLYMYER ENGINEER S 1101 Marina Village Parkway, Suite 100 Alameda, California 94501 Phone: 510.521.3773 Fax: 510.865.2594 DWQ Central Files N.C. Division of Water Quali 512 N. Salisbury Street Raleigh, North Carolina 27604 We are sending you: Letter of Transmittal Date: May 23, 2018 Job No.: 208029 -CLT Via: FedEx Express Saver Copies Date No. Description 2 5/15/18 NCG080624 Semi-annual Stormwater Discharge Monitoring Report for FedEx Freight, Inc. - CLT located in Charlotte, NC Remarks: Blymyer Engineers, Inc. is submitting the enclosed Storm Water Discharge Monitoring Report (DMR) for the January —June 2018 Monitoring Period on behalf of FedEx Freight, Inc. Please address any questions concerning the DMR to Nina Schittli at (800) 753-3773, ext. 139. Thank you. Copy To: Signed: File Maribel Topete, Blymyer Engineers, Inc. Barney Smith, FedEx Freight, Inc. — CLT Brenden Rose, FedEx Freight, Inc. r. - s Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG080000 CERTIFICATE OF COVERAGE NO. NCGO80624 FACILITY NAME FeclEx Freight, Inc. - CLT COUNTY Mecklenburg ^ PERSON COLLECTING SAMPLES Barney Smith LABORATORY PAR Laboratories Lab Cert. # 20 Comments on sample collection or analysis: Date submitted 12/12/18 © p: r � 11 l C r)SAMPLE COLLECTION YEAR 2018 C�JSAMPLE PERIOD ❑ 1an-June ® July -Dec DEC 14 2018 or ❑ Monthly) (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA CENTRAL FILES ❑Zero -flow ❑Water Supply ❑SA DWR SECTIO'? ®Other C PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? X yes _no (If yes, report your analytical results in the table immediately below) Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable) ❑ No discharge this period' Outfall No. Date Sample Collected, mo/dd/yr _ 00530 00400 00556 Total Suspended Solids, mg/L pH, Standard units Non -Polar Oil and Grease/TPH EPA Method 1664 (SGT-HEM), mg/L New Motor Oil Usage, Annual average gal/mo Benchmark - 50 or 200 see permit Within 6.0 _ 9.0 - 15 - - 001 11/12/18 15 7.0 <7.9 1 600 gal/month Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) Outfal l - No. Date Sample Collected, mo/dd/yr 00556 ' 00530 00400 Non -Polar Oil and Grease/TPH EPA Method 1664 (SGT-HEM), mg/L Total Suspended Solids, mg/L pH, Standard.units Permit Limit - 15 50 or 100 see permit 6.0 — 9.0 1 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-250 last revised April 11, 2013 Page I of 2 x STORM EVENT CHARACTERISTICS: Date 4 24 18 (first event sampled) Total Event Precipitation (inches): 1.50 Date (list each additional event sampled this reporting period and rainfall amount) 11 12 18 Total Event Precipitation (inches): 1.25 Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier Z 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 ❑ 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 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: "1 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 apgsignif)(ant pgf%lties for submitting false information, including the possibility of fines and imprisonment for knowing violations." re of Permittee) C G� (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wci/ws/su/npdessw#tab-4 S WU-250 last revised April 11, 2013 Page 2 of 2 STORMWATER DISCHARGE OUTFALL (SDO) ANNUAL SUMMARY DATA MONITORING REPORT (DMR) / SPPP Annual Update DATA REVIEW FORM Calendar Year 2018 Certificate of Coverage (COC) No. NCGO80659 This monitoring report summary of the calendar year should be kept on file on -site with the facility SW 10 2019 Facility Name: UPS Ground Freight, Inc. -Morrisville CENTRAL FILES' County: Wake "R SECTION Phone Number: 919-790-7474 Total no. of SDOs monitored: Outfall No. SDO-001 Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes No FRI If this outfall was In Tier 2 last year, why was monthly monitoring discontinued? Enough consecutive samples below benchmarks to decrease frequency Received approval from DWQ to reduce monitoring frequency ❑ Other El Was this SDO monitored because of vehicle maintenance activities? Yes FAI No EJ Total Parameters, (units) Rainfall, Inches Total Suspended Solids, (mg/L) pH, (Standard Units) Non -Polar Oil and Grease/TPH EPA Method 1664 (SGT-HEM), (mg/L) Benchmark N/A 50 or 100 see permit Within 6.0-- 9.0 15 Date Sample Collected 01/28/2018 1.19 7.2 7.44 < 5.0 10/26/2018 1.69 11.5 7.22 < 5.0 Outfall No. Is this outfall currently in Tier 2 (monitored monthly)? Yes F No Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No If this outfall was in Tier 2 last year, why was monthly monitoring discontinued? Enough consecutive samples below benchmarks to decrease frequency Received approval from DWQ to reduce monitoring frequency Other Was this SDO monitored because of vehicle maintenance activities? Yes No Total Parameters, (units) Rainfall, Inches Total Suspended Solids, (mg/L) pH, {Standard Units) Non -Polar Oil and Grease/TPH EPA Method 1664 (SGT-HEM), (mg/L) Benchmark N/A 50 or 100 see permit Within 6.0-9.0 15 Date Sample Collected "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: Date: For questions, contact your local Regional Office UPS Ground Freight, Inc. - Morrisville SWU-264 - Generic Annual DMR Last revised 5/17/2013 Outfall No. Is this outfall currently in Tier 2 (monitored monthly)? Yes No Was this outfall ever In Tier 2 (monitored monthly) during the past year? Yes No If this outfall was in Tier 2 last year, why was monthly monitoring discontinued? Enough consecutive samples below benchmarks to decrease frequency ❑ Received approval from DWQto reduce monitoring frequency Other Was this SOO monitored because of vehicle maintenance activities? Yes No Total Rainfall, inches Parameters, (units) Total Suspended Solids, (mg/L) pH, (Standard units) Non -Polar Oil and Grease/TPH EPA Method 1664 (SGT-HEM), (mg/L) Benchmark Date sample Collected N/A 50 or 100 see permit Within 6.0 — 9.0 15 Outfall No. Is this outfall currently In Tier 2 (monitored monthly)? Yes No ❑ Was this outfall ever In Tier 2 (monitored monthly) during the past year? Yes ❑ No ❑ If this outfall was in Tier 2 last year, why was monthly monitoring discontinued? Enough consecutive samples below benchmarks to decrease frequency El Received approval from DWQ to reduce monitoring frequency ❑ Other ❑ Was this SOO monitored because of vehicle maintenance activities? Yes No Total Rainfall, inches Parameters, (units) Total Suspended Solids, (mg/L) PH, (Standard Units} Non -Polar Oil and Grease/TPH EPA Method 1664 (SGT-HEM), (mg/L) Benchmark Date Sample Collected N/A 50or 100see permit Within 6.0--9.0 15 "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 property 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 hest of my knowledge and belief, true, accurate, and complete. 1 am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." Signature: lvac� Date: r `t " L (� ` For questions, contact your local Regional Office UPS Ground Freight, Inc. - Morrisville SWU-264 -Generic Annual DMR Last revised $117/2013 �AVs AW- E N G I N E E R S 1101 Marina Village Parkway, Suite 100 Alameda, California 94501 Phone: 510.521.3773 Fax: 510.865.2594 DWQ Central Files N.C. Division of Water Quality 512 N. Salisbury Street Raleigh, North Carolina 27604 We are sending you: Letter of Transmittal Date: November 27, 2017 Job No.: 208029 -CLT Via: FedEx Express Saver Copies Date No. Description 2 11/17/17 NCGO80624 Semi-annual Stormwater Discharge Monitoring Report for FedEx Freight, Inc. - CLT located in Charlotte, NC G. Pi\f=n GrNT �L Fii-E w+rrr� ws.+3 1 14jDI Remarks: Blymyer Engineers, Inc. is submitting the enclosed Storm Water Discharge Monitoring Report (DMR) for the July - December 2017 Monitoring Period on behalf of FedEx Freight, Inc. Please address any questions concerning the DMR to Nina Schittli at (800) 753-3773, ext. 139. Thank you. Copy To: Signed: File Nina Schittli, Blymyer Engineers, Inc. Barney Smith, FedEx Freight, Inc. — CLT Brenden Rose, FedEx Freight, Inc. Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG080000 Date submitted CERTIFICATE OF COVERAGE NO. NCGO80624 FACILITY NAME FedEx Freight, Inc. -_CLT COUNTY Mecklenburg PERSON COLLECTING SAMPLES Barney Smith LABORATORY PAR Laboratories Lab Cert. # 20 Comments on sample collection or analysis: SAMPLE COLLECTION YEAR 2017 SAMPLE PERIOD ❑ Jan -June ® July -Dec or ❑ Monthly) (month) DISCHARGING TO CLASS ❑ORW ❑HQW [—]Trout ❑PNA ❑Zero -flow ❑Water Supply []SA ®Other C PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? X yes _no (if yes, report your analytical results in the table immediately below) Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable) ❑ No discharge this period' Outfa I I No. Date Sample Collected, mo/dd/yr 00530 00400 00556 Total Suspended Solids, mg/L pH, Standard units Non -Polar Oil and Grease/TPH EPA Method 1664 (SGT-HEM), mg/L New Motor Oil Usage, Annual average gal/mo Benchmark - 50 or 100 see permit Within 6.0 — 9.0 15 - 001 10/23/17 14 7.0 <6.8 600 gal/month Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) Outfa I l No. Date Sample Collected, mo/dd/yr 00556 00530 00400 Non -Polar Oil and Grease/TPH EPA Method 1664 (SGT-HEM), mg/L Total Suspended Solids, mg/L pH, Standard units Permit Limit - 15 50 or 100 see permit 6.0 -- 9.0 I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-250 last revised April 11, 2013 Page t of 2 1 7 STORM EVENT CHARACTERISTICS: Date 03 08 17 (first event sampled) Total Event Precipitation (inches): 0.75 Date 10 23 17 (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): 1.98 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: • 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 iE SECTION B. ■ TIER 3, HAS YOUR FACILITY HAD 4 CR MORE BENCHMARK EXCEEDENCES 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 oriainal and one copy of this DMIt includina all "No Discharge" reports. within 30 days of receipt of the lab results !or at end of monitorina 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 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 arej,�Vificant penaltjA for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) rr 1/zn17 (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wp/ws/su/npdessw#tab-4 SWU-250 last revised April 11, 20 Page 2 of 2 Semi-annual Stormwater Discharee Monitorine Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted CERTIFICATE OF COVERAGE NO. NCGO80624 RCL �v SAMPLE COLLECTION YEAR 2017 FACILITY NAME Fed Ex Freight, Inc. - CLT Gp�R 13 ��1� SAMPLE PERIOD ® Jan -June ❑ July -Dec COUNTY Mecklenburg or ❑ Monthly' month PERSON COLLECTING SAMPLES Barney Smith �[NTRACT ON DISCHARGING TO CLASS ❑ORW ❑HQW [:]Trout❑PNA LABORATORY PAR Laboratories Lab Cert. # 20 pWR 5E ❑Zero -flow ❑Water Supply [:]SA Comments on sample collection or analysis: ®Other C PLEASE REMEMBER TO SIGN ON THE REVERSE Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? X yes _no (if yes, report your analytical results in the table immediately below) Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable) ❑ No discharge this period' Outfal l No. Date Sample Collected, mo/dd/yr 00530 00400 00556, Total Suspended Solids, mg/L pH, Standard units Non -Polar Oil and Grease/TPH EPA Method 1664 (SGT-HEM), mg/L New Motor Oil Usage, Annual average gal/mo Benchmark - 50 or 100 see permit Within 6.0 — 9.0 15 - 001 03/08/17 14 6.9 <6.2 600 gal/month Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) Outfal l No. Date Sample Collected, trio/dd/yr 00556 00530 00400 Non -Polar Oil and Grease/TPH EPA Method 1664 (SGT-HEM), mg/L. Total Suspertdecl Solids, mg/L pH, Standard units Permit Limit - -15 50 or 100 see permit . 6.0 _ 9.0 1 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-250 last revised April 11, 2013 Page I of 2 STORM EVENT CHARACTERISTICS: Date 03 08 17 (first event sampled) Total Event Precipitation (inches): 0.75 Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): 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: + A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 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 ANYONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy at this DMR, including all "No Discharge" re oM, 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 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 sLRfr ficant penalties fopg9bmitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) 3/z 3 (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr,org/web/wq/ws/su/npdessw#tab-4 S W U-250 last revised April 11, 2013 Page 2 af2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted CERTIFICATE OF COVERAGE NO. NCGO80624 FACILITY NAME FedEx Freight. Inc. - CLT COUNTY Mecklenburg PERSON COLLECTING SAMPLES Barney Smith LABORATORY PAR Laboratories Lab Cert. # 20 Comments on sample collection or analysis: SAMPLE COLLECTION YEAR 2017 SAMPLE PERIOD ® Jan June ❑ July -Dec or ❑ Monthly' (month) DISCHARGING TO CLASS ❑ORW ❑HQW .❑Trout ❑PNA ❑Zero -flow ❑Water Supply ❑SA ®Other C PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? X yes _no (if yes, report your analytical results in the table immediately below) Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable) ❑ No discharge this period' Outfall 5. bate hx 00530 -No Sample Colldcted, TTryotal}r5usperidediH,x'NorrPolar DEl and Orease/i`PH EPA Ne�iir Motor Oil Usage; mp/dd yr = ..4R! y� Solitls,'mg/L� - S .yam 1j `Standard un _ _ -'." f -�'!'� Ci^.-' f .�y{r'T Method 1G54{5GT-HEM], rng/L _� .� =_. r Annual a�erage;ga!/mo Benchmark -- _ - 50or 'TLT-5 M�sl3-T�i'J!^+x.�=' �.'[� r300 see.permit - -- YP` -.. -ice!-.• i F� Within 6 0„09 a� :. --- �"'"".,--•� -- ���� - - — =15 __ -- - i._-s^' Rh.�� � �'r.� - -- 001 03/08/17 14 6.9 c6.2 600 gal/month Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) Outfall Date t ti 00556 = 00530 :. 00400 q o: N a. Sam le Collected p , }T „,„ , o=Polar Oil and Grease/TPH EPAs e#hod; - n r _ _Tr'tt-CF Total Suspend _ 'SnlidsT- r ,F - _ ;pH .,_ _`.f�ll,,'"s.d C. -- - _ Fi'� - - ---- .k *",'3'.•: p:.. �65�4 rng/L- .� �,..: s c a'.. Rr .F "lit - - -Standaid . .-ma/dd/yrr'�F �. 1s, _ _ .._-_.. ,:,..._ �'�..>� n' p:. (SCT-HEM) 1- G..mgJ)t� _. ,is t .. .': _.r t... r,.. -., units �f •.Fttk'i I Permlt;L mlt w.=s:i' --: ---' fe = •'T� ..1 ✓YI � _'�.. — 'a` r.�'�4 yc1.Y. -- = Fs 15 s'- _ - -i3 m 50-or 1DEl:see °- —— �- 5 0 - 9 0 ,' _ _ _ permit I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-250 last revised April 11, 2013 Page 1 of 2 STORM EVENT CHARACTERISTICS: Date 03 08 17 (first event sampled) Total Event Precipitation (inches): 0.75 Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, rer x, 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 Il SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES 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 on final and one copy of this DMR including all "No Discharge" re its within 30 days of receipt of the lab results or at end of monitoring eriod in the case of "No Discharge" reportsl 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 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 sjgrjficant perjalties foys9bmitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) Z3 (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wg/ws/su/npdessw#tab-4 SWU-250 last revised April 11, 2013 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted CERTIFICATE OF COVERAGE NO. NCGO80624 SAMPLE COLLECTION YEAR 2015� FACILITY NAME FedEx Freight, Inc_. - CLT SAMPLE PERIOD ❑ Jan -June ® July -Dec COUNTY Mecklenburg or ❑ Monthly' (month) PERSON COLLECTING SAMPLES Gary DISCHARGING TO CLASS ❑ORW ❑HQW [:]Trout❑PNA LABORATORY PAR Laboratories Lab Cert. # 20 =r ❑Zero -flow ❑Water Supply ❑SA Comments on sample collection or analysis: ®Other C PLEASE REMEMBER O SIGN ON THE REVERSE 4 Di his facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? x d t y p g g s e oto p yes � o (if yes, report your analytical results in the table immediately below) k/to Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable) ❑ No is period' 4plaz Outfall No' :Date ` ' Sample Collected, mo/dd/yr QQ530 00400 �00556 ;Total°Suspended> Solids mg/L- pH, -,Standard units Non -Polar Oil and`Grease/TPH EPA ,..u,. Metfiod°1664 (SGT=HEM), mg/L New,Motor Oil Loge, ;Annual average:gal/mo Benchmark - 50 or 100 see permit Within 6 0 -,9.0, w7.0 001 12/01/25 18 <6.8 600 gal/month Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) outfall - .:Date 00556 .00530 W00 No. SamIe.Collected p Non -Polar Oil and Grease/TPH'EPA Method Total -suspended Solids,: pH -mo/dd/yr 16.64 (SGT HEM), mg/L mg/L , Starada'Fdunits Permit Limit 15 r k . 50 or 100 see permit 6 0 90 1 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here- SWU-250 last revised April 11, 2013 Page I of 2 STORM EVENT CHARACTERISTICS: Date 12 01 15 (first event sampled) Total Event Precipitation (inches): 1.75 Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): 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: • 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 11 SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE 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 for 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 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 areAnificant penalties fobsubmitting false information, including the possibility of fines and imprisonment for knowing violations." of 1 17lzv�� (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/"su/npdessw#tab-4 SWU-250 last revised April 11, 2013 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 CERTIFICATE OF COVERAGE NO. NCGO80624 FACILITY NAME FeclEx Freight. Inc. - CLT COUNTY Mecklenburg PERSON COLLECTING SAMPLES Ga[y Coles LABORATORY PAR Laboratories Lab Cert. # 20 Comments on sample collection or analysis: Date submitted i SAMPLE COLLECTION YEAR 2015 RECE� V ED SAMPLE PERIOD ® Jan -June ❑ July -Dec AUG 0 7 2015 or ❑ Monthly' (monthl DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA CENTRAL FILES ❑Zero -flow ❑Water Supply [:]SA DWR SECTION ®Other C PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? X yes _no (if yes, report your analytical results in the table immediately below) Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable) C�2 ❑ No discharge this periods �C O_ouifail" No" > Date Sample Collected _, mo/dd/Yr . `` .- 00530 00400 00556 Suspended Total Sended - g/ Solids m L pH, - Standard -units Nor' -Polar Oil and Grease/TPH EPA Method 1664 SGT-HEM). m L ( g/ New Motor..Dil Usage, Annual'average gal/rrioi Benchmark - 50 or 100 see permit Within 6.0 = 9.0 15 - 001 06/29/15 9.50 7.20 <5.0 600 gal/month Part B: Oil/water Separators and Secondary Containment Areas at. Petroleum Bulk Stations and Terminals (If applicable) OutFall.. No. Date Sample Collected, mo/dd/yr 00556 00530 0040O,,, Non-PolarOil and Grease/TPH EPA Method'- 1664 (SGT-HEM), mg/L Total Suspended Solids, mg/L pH, t. Standard units Permit Limit - 15 50 or 100 see permit 6:0`- 9:0`'. I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-250 last revised April 11, 2013 Page I of 2 '.. STORM EVENT CHARACTERISTICS: Date 06 29 15 (first event sampled) Total Event Precipitation (inches): 1.06 Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Ter 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 ❑ 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 o "No Discharge" re arts 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 persons directly responsible for athering the ' ormation, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. lam aware that there arificant p�ialties for s mitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) .3 r %,�s ( Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.o[g/web/wq/ws/su/npdessw#tab-4 SWU-250 last revised April 1], 2013 Page 2 of 2 - Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 CERTIFICATE OF COVERAGE NO. NCGO80624 FACILITY NAME FedEx Freight, Inc. - CLT COUNTY Mecklenburg PERSON COLLECTING SAMPLES Gary Coles LABORATORY PAR Laboratories Lab Cert. # 20 Comments on sample collection or analysis: Date submitted SAMPLE COLLECTION YEAR 2015 RECEIVED SAMPLE PERIOD ® Jan -June ❑ July -Dec JUL 2Q16 or ❑ Monthly'_ (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA CENTRAL FILES []Zero -flow ❑Water Supply [—]SA DWR SECTION ®Other C PLEASE REMEMBER TO SIGN ON THE REVERSE -) Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? X yes _no (if yes, report your analytical results in the table immediately below) Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable) ❑ No discharge this period' Outfall No. Date Sample Collected, mo/dd/yr 00530 00400 00556 Total Suspended Solids, mg/L pH, Standard units Non -Polar Oil and'Grease/TPH EPA Method 1664 (SGT-HEM), mg/L New Motor Oil Usage, Annual average gal/mo Benchmark - 50 or 100 see permit Within 6.0-9.0 15 - 001 04/22/16 124 7.1 39 600 gal/month Part 8: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) Outfa I I No. Date Sample Collected, • mo/dd/yr 00556 00530 00400 Non -Polar Oil and Grease/TPH EPA Method 1664 (SGT-HEM), mg/L Total Suspended Solids, mg/L pH, Standard units Permit Limit - 15 50 or 100.see permit 6.0-9.0 i For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-250 East revised April 11, 2013 Page 1 of 2 STORM EVENT CHARACTERISTICS: Date 04 22 16 (first event sampled) Total Event Precipitation (inches): 1_0 Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or rer 3 responses. See General Permit text FOR PART AAND 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 ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one coon of this DMR, including all "No Discharae" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case of "No Discharae" 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 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 Xr' scant penalties forAubmitting false information, including the possibility of fines and imprisonment for knowing violations." of Pe -71L5%Zola (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wg/ws/su/npdessw#tab-4 SWU-250 last revised April 11, 2013 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 CERTIFICATE OF COVERAGE NO. NCGO80624 FACILITY NAME FeclEx Freight, Inc. - CLT COUNTY Mecklenburg PERSON COLLECTING SAMPLES Barney Smith LABORATORY PAR Laboratories Lab Cert. # 20 Comments on sample collection or analysis: Date submitted RECEIVED SAMPLE COLLECTION YEAR 2016 SAMPLE PERIOD ❑ Jan -June ® July -Dec OCT 2 5 2016 or ❑ Monthly' month CENTRAL FILES DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA DWR SECTION ❑Zero -flow ❑Water supply [:]SA ®Other C PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? X yes _no (if yes, report your analytical results in the table immediately below) Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable) ❑ No discharge this period' Outfall No. Date Sample Collected, mo/dd/yr 00530 00400 00556 _ Total Suspended Solids, mg/L pH, Standard units Non -Polar Oil and Grease/TPH EPA Method 1664 (SGT-HEM), mg/L New Motor Oil Usage, Annual average gal/mo Benchmark - 50 or 100 see permit Within 6.0 - 9.0 15 - 001 09/29/16 41 6.3 <5.3 600 gal/month Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) Outfal I No. Date Sample Collected, mo/dd/yr 00556 00530 00400 Non -Polar Oil and Grease/TPH EPA Method 1664 (SGT-HEM), mg/L Total Suspended Solids, mg/L pH, Standard units Permit Limit - 15 50 or 100 see permit 6.0 — 9.0 I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-250 last revised April 11, 2013 Page 1 of 2 STORM EVENT CHARACTERISTICS: Date 09 29 16 (first event sampled) Total Event Precipitation (inches): 2.0 Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): 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: • 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 Il SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE 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 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 penao%s for submitting false information, including the possibility of fines and imprisonment for knowing violations." ature of io 1 SI01G (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wg/ws/suZnpdessw#tab-44 S W U-250 last revised April 11, 2013 Page 2 of 2