NCS000048 DMR SW

Permit Number: NC S000048 or
Certificate of Coverage Number: NCG
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
SAMPLES COLLECTED DURING CALENDAR YEAR: 2015
(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 Chemol COUNTY Guilford
PERSON COLLECTING SAMPLE(S) Chasity Hart
CERTIFIED LABORATORY(S) R&A Laboratory Lab # 34
Lab #
Part A: Specific Monitoring Requirements
(SIGNATURE OF PERMITTEE Ok DESIGNEE)
By this signature, I certify that this report is accurate
complete to the best of my knowledge.
Outfall Date
No. Sample
50050
00556
00530
Collected
Total Oil & Grease pH TSS
Flow
COD BOD -5 Total
Phos horous
Total Nitrogen
mo/dd/ r
MG m Std units ro
m mg/1 m
m l
1 09/25/2015
63.14 < 5 6.0 21.6
70 13.0 0.225
<2
61
Nitrate+Nitrite
m
2
0.621
IV I NA L FI
TI
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes X no
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall Date
No. Sample
Collected
50050
00556
00530
00400
Total
Flow
Oil & Grease
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/dd/ r
MG
mg/1
MIO
Form SWU-246-051100
Page I of 2

STORM EVENT CHARACTERISTICS:
Date 9/25/15
Total Event Precipitation (inches): 2.11
Event Duration (hours): 6
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours):
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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."
of Permittee) (Date)
Form SWU-246-051100
Page 2 of 2