NCG020883_DMR_20200627

STORMWATER DISCHARGE MONITORING REPORT (DMR)
Please Mail Original And One Copy To Mailing Address Below
GENERAL. PERMIT NO. NCG020000
Part A: Facility Information
/.), f za zo
Samples Collected In Calendar Year: 269 p (all samples shall be reported within 30 days following monitoring period) -
Certificate Of Coverage No. NCG02 6dW $X � County of Facility
Facility Name Cafa vba C( M 'ne Name of Laboratory
ui�lcen(764
Facility Contact S fe�en b lm' Lab Certification ll ama
Facility Contact Phone No. ( 26Y )32D nY3 7
Part B: Land Disturbance and P nrv_cc Arne as,"i.,,.:" n ..:
Outfall.
No.
Reeeiving Stream
Name
Date'
S005.0
Otl530 :.
`.00076 ;
a05d5'
Sam ,te
P
Collected'
Total
Plow
Total
Suspended.
Solids.
Turbidity..
Settleable.
Solids;.:.
mo/dd/ r.
MG
m 1
NTUs '
ini/I 't
!;.Folk Ca+a.t•, Q.
5 20
l . p
c/•O
�.q
CO. I
Part D: Storm Event Characteristics
Total Event Precipitation (inches): 0.20
Event Duration (hours): 3
Part E: Certification
RFrr--l" l w }
JUL 06 ZGZ'i
Part C: Vehicle Maintenance ddonitoring Re utrements
--Outfall
No.
Recelving Stream
Name
D3to
50050
00556
00530
Sample
Coliecta
l
Tota!
Flaw
Oil nnd.
Grease
Total
. Suspeiiiie
Solids
-
mo/dd/yr
MG
m /1=...
mil
CENTRAL FILE:: Total Event Precipitation (inches):
90M SECTION Event Duration (hours):
(if a separate storm event is sampled)
"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 of Permittee) (Date)
Part F: Mailing Address
Attn: Central Files, DENR, N.C. Division of Water Quality,1617 Mail Service Center, Raleigh, NC 27699-1617
Swu