NCG060348 DMR SW (5)

1 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division Of Water Quality General Permit No. NCG060000 x -�
Date submitted Dq) '\) 01(n
CERTIFICATE OF COVERAGE NO. NCGO6 U Q D 0 I SAMPLE COLLECTION YEAR a U Lo
FACILITY NAMES W i9f(\C MIA Y\ ( O(\ Up i L V. FACILITY ACTIVITIES INCLUDE(check all that apply):
COUNTY l ',`\(�-fri 1 0 use/process meats 4 use animal fats/byproducts
PERSON COLLEdING SAMPLES \C-Ph(Pr-1 13YUUJ Y) 1 DISCHARGING TO SAO-WATERS? EYES ! NO
LABORATORY 1\1\1 ' k /I\ J. lab Cert.#
ONCri11A>0 PLEASE REMEMBER TO SIGN ON THE REVERSE-
Part A:Stormwater Benchmarks and Monitoring Results I Total event rainfall 2 5 i 0'
f or ❑No discharge this period3
Outfall No. SIample Collected, TSS, pH, i COD, Oil and Grease, Fecal Coliforms, Enterococcil,
I mo/dd/yr mg/L Standard units I mg/L mg/L Colonies per 100 ml Colonies per 100 ml
Benchmark j - 100 or 504 Within 6.0—9.0 I 120 30 1000 500
1 10'6/0 l I Lo Q 1.\I ! 13 1 7 O,000
a 1U ) I .f)(49I o 1,'1a ' ia(. 6 ?(P0!0003 1()�1i Ij 361.LI r1,t.�(0 Col-- 5 ?(00)000 --
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°�E D.:-,v F
1 Only applies to facillties that use/process meats. SEP (� 2( Ib
2The total precipitation must be recorded using data from an on-site rain gauge. CENT
3 For sampling periods with no discharge at outfalls.You must still submit this discharge monitoring report with a checkmark here. RAL FILES
4See General Permit text,Table 3,identifying the especially sensitive receiving water classifications where the more protective benchmark aappril I s. ECTION
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑yes [ 'no (if yes, complete Part B)
t
Part B:Vehicle IVjaintenance Area Monitoring Results:only for facilities averaging>55 gal of new motor oil/month.
Outfall No. Sample Collected, Oil and Grease, 1 TSS, pH, New Motor Oil Usage,
mo/dd/yr mg/L I mg/L Standard units Annual average gal/mo
Benchmark - 30 100 or 504 6.0—9.0 -
1 1
j
s Only applies to fafilities that use/process meats.
2The 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 subrbit 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.
1 j
SWU-249 Last Revised:October 18,2012
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•
*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 i1 NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES b NO
REGIONAL OFFICE CONTACT NAME: 'f'N h '3UjQ1
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 ervice Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATIOIII 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 designee to assure that qualified personnel properly g ither and evaluate the information submitted. Based on my inquiry of the
person or persons s who manag- the system, or those persons directly responsible for gathering the information, the information submitted is,
to the bey of m knowle.:e a.: .elief,tr accurate, and complete. I am aware that there are significant penalties for submitting false
informati.n, inclludi. th- •oss'•' ' s t;,nd im.risonmet for knowing violations."
dol'
(Sign.:o'orsf Pebmi - - (D e)
Additional copies of this form may be downloaded at: htto://portal.ncdenr.orR/web/wq/ws/su/nodessw#tab-4
SWU-249 I ;
Last Revised:October 18,2012
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