NCS000321 DMR SW (5)

PERMIT COVERAGE NO. NCS0000321
FACILITY NAME Lubrizol -Gastonia
PERSON COLLECTING SAMPLE(S)
CERTIFIED LABORATORY(S) Prism Labs
Part A: Specific Monitoring Reauirements
David
STORMWATER DISCHARGE OUTFALL (SDO)
ANALYTICAL MONITORING REPORT
Lab #
Lab #
Outfall
No.
Date
Sample
Collected
Total Biochemical
Flow Oxygen
Demand
Total Chemical Zinc pH
Suspended Oxygen
Solids Demand
mm/dd/ r MG m
m m m
02
1/7/2015
3.5
12 <50 0.12 8.8
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?
(if yes, complete Part B)
Part B: Vehicle Maintenance ActivityMonitoring Re uirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 2015
(all samples collected during a calendar year, shall be reported no later
than 30 days from the date the facility receives the sampling results)
COUNTY Gaston
PHONE NO. 704 915-4165
(SIGNATAIRE OF PERNIMEE OR DESIGNEE)
By this signature, I certify that this report is accurate
complete to the best of my knowledge
Outfall
No.
Date
Sample
Collected
mm/dd/ r
50050
Total Flow
MG
00556
Oil and Grease
m
01051
Lead, Total
Recoverable'
u
38260
Detergents
(MBAS)`
m
00400
pH
unit
New Motor Oil
Usage
al/mo
STORM EVENT CHARACTERISTICS
Date 1/6/2015
Total Event Precipitation (inches): 1.4
Event Duration (hours): 24
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours):
RECEIVED
MAR Q 9 2015
CENTRAL FILES
DWR SECTION
Yes X No
Attn: Central Files
DEHNR
Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
Form MR18
Page 1 of 2

Footnotes:
I Applies only for facilities at which fueling occurs.
Z Detergent monitoring is required only at facilities which conduct vehicle cleaning operations.
"1 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 properlyIgather and evaluate the information submitted. Based on my inquiry of the person -
or persons who manage the "system, or those persons directly responsible'foi gathei ing_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)
31311.5-
(Date)
Form MR18
Page 2 of 2