NCS000515_Outfall Monitoring Form_20200921

CH NA GROVE
STORMWATER
An original. town.
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Permit No.: _/_/_/_/_/_/_/ or Certificate of Coverage No.: N/C/G/_/_/_/_/_/_/ Facility
Name:
Inspector:
Date of Inspection:
Time of Inspection:
Total Event Precipitation (inches):
County: Rowan Phone No.
All permits require qualitative monitoring to be performed during a "measurable storm event."
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site
outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm
interval does not apply if the permittee is able to document that a shorter interval is representative for
local storm events during the sampling period, and the permittee obtains approval from the local DEMLR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.):
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
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2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.):
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 2 3 4 5
7. Is there any foam in the stormwater discharge? ® Yes ® No.
8. Is there an oil sheen in the stormwater discharge? ®Yes ®No.
9. Is there evidence of erosion or deposition at the outfall? Q Yes o No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
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SWU-242, Last modified 07/28/2017