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HomeMy WebLinkAboutNCS000130 DMR SWSTORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Permit Number NCS 000130 FACILITY NAME����u� OCK� tJ kxM PERSON COLLECTING SAMPLE(S) LJ'4 It r d r CERTIFIED LABORATORY(S) Lab # n' ec 1t Lab #& Part A: Specific Monitoring Requirements Outfall DateII I No. Sample Total Collected Rainfall SAMPLES COLLECTED DURING CALENDAR YEAR: O1 5' (This monitoring report shall be received by the Division no later than 30 days from the date the facility receives the sampling results fromthelaboratory.) COUNTY PHONE NO. (!R/ 0) SIGNATURE OF PERMITTEE OR DESIGNEE REQUIRED ON PAGE 2. Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _1,-.<e's _no (if yes, complete Part B) Part B: Vehicle Maintenance Activitv Monitoring Requirements Outfall Date No. Sample Collected 50050 00556 00530 00400 Total Flow (if applicable) Total Rainfall Oil & Grease (if appl.) Non -polar O&G/TPH (Method 1664 SGT -HEM), if appl. Total Suspended Solids pH New Motor Oil Usage mo/dd/ r MGinches mg/ m /l unit al/mo D #I IS � � o Form SWU-247, last revised 2/2/2012 �` Pagel of 2 STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Permit Number NCS C)d d l 3 V FACILITY NAME �Qrt� ll�� CRy C -r` ` k py- PERSON COLLECTING SAMPLE(S) M vUPp— CERTIFIED LABORATORY(S) Lab # QST r QC SnJL Lab #--jZS Part A: Specific Monitoring Requirements SAMPLES COLLECTED DURING CALENDAR YEAR: 1� (This monitoring report shall be received by the Division no later than 30 days from the date the facility receives the sampling (t results from the laboratory.) COUNTY PHONE NO. 1C�) 4� SIGNATURE OF PERMITTEE OR DESIGNEE REQUIRED ON PAGE 2. 1 Outfall DateII 1 Sample Collected I 1 : 1 Rainfall 00556 .� 00530 00400 Total Flow (if applicable) -- Oil & Grease (if appl.) Non -polar O&G/TPH (Method 1664 SGT -HEM), if appl. Total Suspended Solids pH New Motor Oil Usage mo/dd/ r MG inches m /I m /l unit al/mo Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? / _no (if yes, complete Part B) Part B: Vehicle Maintenance Activity Monitoring Requirements Outfall Date No. Sample Collected 50050 00556 00530 00400 Total Flow (if applicable) Total Rainfall Oil & Grease (if appl.) Non -polar O&G/TPH (Method 1664 SGT -HEM), if appl. Total Suspended Solids pH New Motor Oil Usage mo/dd/ r MG inches m /I m /l unit al/mo Form SWU-247, last revised 2/2/2012 Pagel of 2 STORM EVENT CHARACTERISTICS: Date QOS J <- 0, S' Total Event P ecipitation (inches): Event Duration (hours):to �� (only if applicable — see permit.) (if more than one storm event was sampled) Date Total Event Precipitation (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 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." (Signature of Permittee) fl! 7//� (Date) Form SWU-247, last revised 2/2/2012 Page 2 of 2