NCG120066 - DMR SW

STORMWATER DISCHARGE OUTFALL(SDO) •
I MONITORING REPORT n
Permit Number:NCS P L G' i 20000 _ or SAMPLES COLLECTED DURING CALENDAR YEAR: I t X .20) 5
Certificate of Coverage Number:NCG (This monitoring report shall be received by the Division no'titer than 30 days from
the date the facility receives the sampling results from the laboratory.)
FACILITY NAME VU (e: i �o ij �ld�Y� � i
A�
• l' l I
�
PERSON COLLECTING SAMP (S) a •r+NE NO. 3: .'
CERTIH' ED LABORATORY(S) '0 f 151 iC.Q Lab# ` Mm 2 GNATURE OF PERMITTEE OR DESIGNEE)
CENTRAL X11- �signature,I certify that this report is accurate
DWR SECYI plete to the best of my knowledge.
Part A:Specific Monitoring Requirements
Outfall Date .:50050
No. Simple Total Total
Collected FloW(if app.) Rainfall
mo/ddlyr MG: inches:
a `/, 47/5 ./V2 / W
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 Date 50050 005 00530 00400 .
No Sample Total Flow Total Rainfall Oil&Gr ase Non-po r ;i E ; pH; New Motor 011
Collected :(if applicable) (if appi.) Ananaule4 ' Usage
SGT II M f), r
mo/dd/yr MG . inches AmWl mail Units gal/mo
Form SWU-246-062310
Page 1 of 2

STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Division of Water Quality
Date t' Z 6.) IS Attn:Central Files
Total Event Precipitation(inches): 1617 Mail Service Center
Event Duration(hours): (only if applicable—see permit.) Raleigh,North Carolina 27699-1617
(if more than one storm event was sampled)
Date
Total Event Precipitation(inches):
Event Duration(hours): (only if applicable—see permit.)
"I certify,under penalty of law,that this document and all attachments were prepared under my direction or supervision in accordance with
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the per
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 ermittee)
(Date)
Form SWU-246-062310
Page 2 of 2

STORM WATER DISCHARGE OUTFALL(SDO)
• MONITORING REPORT
Permit Number:NCS A/ 6* i,Z,0000 , or SAMPLF,S COLLECTED DURING CALENDAR YEAR:,Alarcit. 20/5
Certificate of Coverage Number: NCG O()6 b (This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
FACILITY NAME lilice42 a 6arniti 1/11-6?"5" ---" COUNTY I I
PERSON COLLECTING SAMPLE(S) ,IVI? PH I 0. Vo
CERTIFIED LABORATORY(S)ACC- q I ca- Lab# 115—
Lab# (SIGNATURE OF PERMITTEE OR DESIGNEE)
• By this signature,I certify that this report is accurate
complete to the best of my knowledge. •
Part A: Specific Monitoring Requirements •
• .1
• Outfall ..• Date • 50050 Effeninlig RESIESERIUSENIMMInaiiinill
,
No
.Sample
. , Total•. • . eietttij,;41..;,,4,7:. ;
• '1'
Collected, • , •;•=1 i:(2k:vf• ; ; •
; , • . .•:•••■•• c,040e. •; ,.;.•, •
111°M di ligingEng
11162MMAYIR--
11111111111111M11=1111111111
NUMME1111
= Egimmr*
U11111111111111.
11111111111111111116111=111111
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•;"-. Date ••■;;;,•` .50050 005 00530. 00400 : •• •
No. Sample. Total Flow It'f' '0 • 11, 'New Maim'Oil kppI)F.,e„115% ....Po
•• • collected :;••• (1f applicable)
e 'it4ft,..+ASpA4 itMottiiiit1464•47 .8011ds014.)-i-'coi:
• • 4..
a 1,
• • , . " ..• • :;
' ;• --, • • ;
• !. : • ; ..• • •
mo/ddi r MG r"'••• inches::::f:iiP,Ti:?.4'1'; "II •.•:., gal/mo •; ••••
•
•
Form SWU-246-062310
1 Page 1 of 2

STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Division of Water Quality
Date 1�C ivy+v 20 Attn: entral Files
Total Event Precipitation(inches): v 1617 all Service Center
Event Duration(hours): (only if applicable—see permit.) Raleig.,North Carolina 27699-1617
(if more than one storm event was sampled)
Date '
Total Event Precipitation(Inches):
Event Duration(hours): (only if applicable—see permit.)
1
"I certify,under penalty of law,that this document and all attachments were prepared under my direction •r 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 ormation submitted is,to the best
of my knowledge and belief,true,accurate,and complete. I am aware that there are significant penalties fl r submitting false information,
including the possibility of fines and imprisonment for knowing violations."
��� '�,� , .....- f.— /...3(Signature of Permittee) (Date)
i III
Form SWU-246-062310
Page 2 of 2