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HomeMy WebLinkAboutNCG060358_DMR_20220307 N(G06 0338 NC Department of Environmental Quality Received STORMWATER DISCHARGE OUTFALL(SDO) MAR 0 7 2022 MONITORING REPORT nI � /+ n/,,r`-�� nn ►n-Salem Permit Number NCS N t,�-�0(�V��l SAMPLES COLLECTED DURING CALENDAR YEAR: ‘„;,, office (This monitoring report shall be received by the Division no later than 30 days from 1 C // the date the facility receives the sampling results from the laboratory.) R FACILITY NAME C e L L Ct.�/ COUNTY CA COUNTY ZJ'd PERSON COLLECTING SAMPLE(S) e_...C(C kQ( 000 I PHONE NO.(7%1)(v) c7 7 I ':_9 c{U I CERTIFIED LABORATORY(S) W Y i e.(n I A C • Lab# Lab# - __ — .T SIGNATURE OF PERMITTEE OR DESIGNEE REQUIRED ON PAGE 2. Part A: Specific Monitoring Requirements Outfall Date 50050 No. Sample Total Total I C011ected Flow(if app.) Rainfall TSS PH_ l� D mo/dd/yr MG inches /001'71/a- (P-6/ ► 011.�/`- .-Li-,(9- (2, i 4-9.5 c/),� z_ 15 Li - -y-9,9- J, 4,2•5 (As" . L15 Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?Oyes Ono (if ycs,complete Part B) Part B: Vehicle Maintenance Activity Monitoring Requirements Outfall Date 50050 00556 00530 00400 No. Sample Total Flow Total Oil&Grease Non-polar Total pH New Motor Collected (if applicable) Rainfall (if appl.) O&G/TPH Suspended Oil Usage (Method 1664 Solids SGT-HEM),if appl. mo/dd/yr MG inches mg/I mg/I unit gal/mo Form SWU-247,last revised 6/12/2015 Page 1 of 2 STORM EVENT CHARACTERISTICS: Mail Original and one copy to: Division of Energy Mineral and Land Resources Date 3-1-1- 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 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." jrZ ^�, c�, 3 (Signature of Permittee) (Date) Form SWU-247,last revised 6/12/2015 Page 2 of 2