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Home My WebLink AboutNCS000222 DMR SW (2)NE STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Permit Number: NCS or : SAMPLES COLLECTED DURING CALENDAR YEAR Certificate of Coverage Number. NCG (This monitoring report shall be received by the Division no later than 30 days from FACILITY NAME l1 the date the facility receives the sampling results from the laboratory.) 1�1 � PERSON COLLECTING SAMPLF.(S 1 I V E ® PCOUNTY HONE N��1 CERTIFIED LABORATORY(S) 5 U I ab O. (C 0) Part A: Specific Monitoring Requirements Lab #-!�kw 15 2015 CENTRAL FILES DWR SECTION (SIGNATURE OFPERM1'1"1'EE OR DESIGNEE) By this signature, I certify that this report is accurate complete to the best of my knowledge. b �u�� gmons or new motor oil per month? i yes, complete Part B) i _ yes _no Part B: Vehicle Maintenance Activity Monito ing Req uirements Outfall Date 500511 No. Sample Total Flow Total Rai�nfaqjl Collected (if applicable) MG I inches 00556 00530 00400 Oil & Grease Total pH New Motor Oil Suspended - Usage Solids m rat 1 Units ...,v.,. Foran SWU-216=112608 - Page I ofN4 STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Permit Number: NCS_ O d0 D&a or Certificate of Coverage Number: NCG FACILI`[ Y NAA'1E CkJ— RSL SGL �pl >Z L PERSON COLLECTING SAMPLE(S) CERTIFIED LABORATORY(S) Lab # Lab # Part A: Specific Monitoring Requirements Date Sample Collected Total Total Flow (if app.) Rainfall Does this facility perform Vehic (if yes, complete Part 13) SAMPLES COLLECTED DURING CALENDAR YEAR: (This monitoring report shall be received by the Division no later than 30 days from the date the facility receive the sampling results from the laboratory.) COUNTY Yi 1 L PHONE NO. (SIGNATURE OF PERMITTEE OR DESIGNEE) By this signature, I certify that this report is accurate complete to the best of my knowledge. - - - -� •�� u3nig 111u1c Ulan :):) gauons of new motor oil per month? _ yes _no Part B: Vehicle Maintenance Activit Monitorin Re wrements Outfall Date 50050 00556 00530 No. Sample Total Flow Tota 'nfall Oil & Grease Total 004(10 Collected (if applicable) pH New Motor Oil Suspended Usage mo/dd/ r MG Solids inches m m Units 1=01-111 S W U-2.36-1 12608 Pagelkof'x L� STORMWATF.R DISCHARGE OUTFALL. (SDO) MONI'T'ORING REPORT - Permit Number: NCS_( or Certificate of Coverage Number: NCG FACILITY NAME PERSON COLLECTING SAMPLE(S) je1 CERTIFIED LABORATORY(S) Lab # Lab # Part A: Specific Monitoring Requirements Outfall Date _ 500511 No. Sample Total Total Collected Flow (if app.) Rainfall MG inches SAMPLES COLLECTED DURING CALENDAR YEAR: (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.) COUNTY t PHONE. NO. (SIGNA'T'URE OF PERMT'I'TEE OR DESIGNEE) By this signature, I certify that this report is accurate complete to the best of my knowledge. Does this facility perform Vehicle Mainten (if yes, complete Part 13) ance Activities using more than 55 gallonm s of new motor oil per onth? _ yes _no Part B: Vehicle Maintena7ffiotal it Monitoring Requirements Outfall Date 00556 00530 00400 No. Sample Flow tat Rainfall Oil & Grease T t 1 10xln I P-�+ Collected (if applicable) o a pH New Motor Oil Suspended Usage Solids mo/dd/yr MG inehPs .....n _ __ krIts 7 .,AF% Form S W U-2 I6i-112608 I' STORM EVENT CHARACTERISTICS: Date Total Event Precipitation (inches): Event Duration (hours): (only if applicable — see pernut.) (if more than one storm event was sampled) Date Ev Total ent Precipitatin (inches): Event Duration (hours): (only if applicable — see permit.) 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 or persons who manage the system, or those persons directly responsible for gathering tthe information,ormation tthe inrormation uOn my �bmitted is tto Person of y ledge and belief, tr accurate, and complete. I am aware that there are significant penalties for submitting false information, e best .k' ludin the ossibilit of tin m risonment for knowing v'o ions. g P y P g i fat Al (Date Form S W U-246-1 12608 Page`Q oN Z(j If