NCG060362_MONITORING INFO_20191216

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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑ HISTORICAL FILE
[ MONITORING REPORTS
DOC DATE
❑
YYYYMMDD

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO, NCGO60000 SAMPLES COLLECTED DURING CALENDAR YEAR; Grn
CERTIFICATE OF COVERAGE NO, NCG06 n36 2, (This monitoring report Is due at the Division no later than 30 dtys from
AL) ��J.V ���j/s� the data the facility receives tha s plln results om the labo
FACILITY NAME Z:!_) 9 ratory,)
PERSON COLLECTING SAMPLES ,ff / PHONE NO, R ^ ^ a+
CERTIFIED LABORATORY Lab # C C' E t Z/ P
AF
FAT — Lab # PLEASE SIGN ON THE REVERSE DEC 16 2019
Part At Specific Monitoring Requirements
CENTfi=tiL FiLEL
EcTlom
Outfall
No.
Date
Sample
Collected,
mo/dd/ r
00530
00400
00340
00556
31616
Total Suspended
Solids,
m
pH,
Standard units
Chemical Oxygen
Demand,
mWL
Oil and Grease,
mg/L
Fecal Collform,
Colonies per 100 ml
Benchmark
100
Within 6.0 — 9.0
120
30
1000
-
tmr —zp
ENE
Note; If you report a sampled value In excess of the benchmark value, or outside the benchmark range for pH, you must implement Tler I or Tier2 responses.
See General Permit text,
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of now motor oil par month? —yes Vol'
(If yes, complete Part B)
Part B; Vehicle Maintenance Activity Monitorinn Remdrements
Outfan
No,
Date
Sample Collected,
mo/dd/ r
00556
00530
00400
Oil and Grease,
m L
Total Suspended Solids,
m
pH,
Standard units
Now Motor Oil Usage,
Annual average al/mo
Benchmark
30
100
610-9.0
Note: If you report a sampled value In excess of the benchmark value, or outside the benchmark range for pH, you must Implement Tier I or Tler 2 responses,
See General Permit text.
STORM EVENT CHARACTERISTICS;
Data`L^L._ (first event sampled)/ 21/
Total Event Precipitation (inches); .(L
Date Qlst each additional event sampled this reporting petlod, and rainfall amount)
Total Event Precipitation (inches);
Mali Original and one copy to:
Division of Water Quality
Attn: DWQ Central Flies
1617 Mall Service Center
Raleigh, North Carolina 27699-1617
S WU-2A 9.102107
Page I oft

"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 falso information, including
the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee) (Date)
S W U•249.102107
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