HomeMy WebLinkAboutNCG080272 DMR SWSTORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG080000
CERTIFICATE OFCOVERAGE NO. NCG08 d r) oZ
FACILITY NAME
PERSON COLLECTING SXMPi ES,—
CERTIFIED LABORATORY Lab #
SAMPLES COLLECTED DURING CALENDAR YEAR: `S
(This monitoring report is due at the Division no later than 0 days from
the date the facility receives he sampling results from the laboratory.)
COUNTY
PHONE NO. — J
Lab # PLEASE SIGN ON THE REVERSE -�
Part A: Vehicle Maintenance Areas Monitoring Requirements /
Did this facility perform Vehicle Maintenance Activities using more than 53 gallons of new motor oil per month? _ yes _no
(if yes, report your analytical results in the table immediately below)
Outfall
Date ' �'
a 1 4al V C u,.. �.u.. ,,.uuoun auu i errmnals
. ,., �
' `i' '';' "'' h'
:',
Collected''
,
�otal;uspen�ed`Shclds„
Sam le.Collected
P, ►
G ease'' u i -. _:,
Oil and r ,'-.Total:Sus"ended , Pg�
MOM
,. ,,�,;�, r.,,,,� , s`
N '" Standard units
Permit:Limit-,
6.0- 9.0
Note: If you report a sampled value to excess of the benchmark value, or outside the
See General Permit text.
Part B: nil/wnter CPnaratnrc and Q0nnn 1-, A _--- n— ------- _ —
00556' '
OffandGrO
m
N6w'M6t6r Oil- Usa e^
Anniial, aVPr9ne nol%ivan
0
range for pH, you must implement Tier 1 or Tier 2 responses.
• u..
Outfa
-
;,. •: �• ; :Date:
a 1 4al V C u,.. �.u.. ,,.uuoun auu i errmnals
. ,., �
' `i' '';' "'' h'
:',
, 530: , Q
400 .) ,7,;; ;a+6i'r'; y: i d,i ;p ;; '{i i.. 0 400
No:.,
Sam le.Collected
P, ►
G ease'' u i -. _:,
Oil and r ,'-.Total:Sus"ended , Pg�
MOM
,. ,,�,;�, r.,,,,� , s`
N '" Standard units
Permit:Limit-,
6.0- 9.0
STORM EVENT HARACTERISTICS:
Date��i a (first event sampled)
Total Event Precipitation (inches): _ C;�,—
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
NOV 2 3 2015
ftR SECTION
Mail Original and one copy to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
S WU-250-102107
Page 1 of 2
"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 possil i ty of fines and imprisonment for knowing violations."
(Signature o Per tt e) (Date)
SWU-250-102107
PaaP I or')