NCS000302_COMPLETE FILE - HISTORICAL_20191010

-° --
STORMWATER DIVISION CODING SHEET
RESUSSIONS .
PERMIT NO.
DOC TYPE
COMPLETE FILE- HISTORICAL
DATE OF
RESCISSION
❑
oo/�l l U ) U
YYYYMMDD

i
STORMWATER DISG,,ARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NC or
Certificate of Coverage Number: NCG
FACILITY NAME r�Y� 5� �{ yl� c �C-)
PERSON COLLECTING SAMPLE(S) ► �-
CERTIFIED LABORATORY(S) Lab #
Lab 4-
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR:--Q-��
(This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sam ling results from the inhoratory.)
COUNTY .1Cz51-?
PHO O. 2-t 43
(9IGNATURK Of PERMITTEE OR DESIGNEE)
By this signature, I certify that this report is accurate
complete•to the best of my knowledge.
Outfall
No.
Date
Sample
Collected
50050
Total
Flow
�+
"ECEI
/F [ aFn
mo/dd/yr
MG
n r T 1
LU:j
n
i'Ir
_c
f
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
Oil and
Grease
Total
Suspended
Solids
pH
New Motor
Oil Usage
moldd/yr
MG
mgn
mgfl
unit
gaUmo
_Form S WU-246-051100
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