NCS000360 DMR SW (2)

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
1
Permit Number NCS -25>0-360 SAMPLES COLLECTED DURING CALENDAR YEAR: O 15
(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.)
FACILITY NAME NI G 14.5 COUNTY QL4 r tq4
PERSON COLLECTING SAMPLE(S) ' I t� ryl j< $ t=1 Tt rna tz PHONE NO. 1 5 1^ � f 2
CERTIFIED LABORATORY(S) Gd ' L4 t` Lab # 5 q 1 (9�) �}
Lab #
SIGNATURE OF PERMITTEE OR DESIGNEE
REOUIRED ON PAGE 2.
Part A: Specific Monitoring Requirements
1
DateSample Total
Collected :pp
Total
Rainfall1
50050
00556
00530
00400
Total Flow
(if applicable)
Total
Rainfall
Oil & Grease
(if appl.)
Non -polar
O&G/TPH
(Method 1664
SGT -HEM), if
a I.
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/dd/ r
MG
inches
m
m /l
unit
gaurno
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes xno
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
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
a I.
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/dd/ r
MG
inches
m
m /l
unit
gaurno
Form SWU-247, last revised 2/2/2012
Page I of 2

STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Division of Water Quality
Date O i �,� 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 -- _ - •^- ,�• : _ - - _ - . ,.-J
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."
Il� (?� SL` 1 .r -
(Signature of Permittee) (Date) -
c
Form S W U-247, last revised 2/2/2012
Page 2 of 2,

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS
FACILITY NAME WI G M 5
PERSON COLLECTING SAMPLE(S) Wr \ 4 f MC t,2
CERTIFIED LABORATORY(S) 'o . Cqr u Lab # Sq 1
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 2 0 ) 5
(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 D u C A 4 r"
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Outfall DateII I
No.
Collected
50050
1
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
MUM
Iti
I MG
inches
TJJJ•� r57 _- 0 - r
m /l
unit
al/mo
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes ,%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
I MG
inches
m
m /l
unit
al/mo
Form SWU-247, last revised 2/2/2012
Page 1 of 2

,STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Division of Water Quality -
DateAttn: Central Files
Total Event Precipitation (inches): C _2'9 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." 7
(Signature of Permittee) (Date)
Form SWU-247, last revised 2/2/2012 t,
Page 2 of 2