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STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS S D O0:3Sy
FACILITY NAME STARPPT Znrcc,
PERSON COLLECTING SAMPLE(S) ,TA c -K K[--NNe D
CERTIFIED LABORATORY(S) JVC 0 A/R 7# // Lab
A/C AoN iF 177/y Lab# 9'77iY
Part A: Specific Monitoring Requirements
ORIGINAL
SAMPLES COLLECTED DURING CALENDAR YEAR: Z O l Ai
(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 _RA/VDaL PH
PHONE NO. (.33b' ) 6-7z - y 10 f
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
: Outfall -Date---
:
'No.
Collected -Aal
- M.
�-
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 81
mo/dd/ r
MG
inches
m
m
unit
al/mo
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes y, no
(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
appl.
Total
Suspended
Solids
pH
New Motor
Oil Usage 81
mo/dd/ r
MG
inches
m
m
unit
al/mo
NUV 19 2014.
G f1'R-�R.iV� OU, . JTy
'ORIAVA l ER FERiviiT71NG
Form SWU-247, last revised 2/2/2012
Page 1 of
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS S` o oc 3S41
FACILITY NAME SrAkP,67'XA10,
PERSON COLLECTING SAMPLE(S) jr-
CERTIFIED
CERTIFIED LABORATORY(S) tvcaniR y�// Lab #1_
JIICDoH a'# 377/y Lab # 377/ y
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: A o /
(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 94AIP0J. PN
PHONE NO. (33 )_ d"72 - o 1 o I
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Sample
im�Collected
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes j!,no
(if yes, complete Part B)
Part B: Vehicle Maintenance Activit„ Mnnitnrino Ranioiraman#m
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
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes j!,no
(if yes, complete Part B)
Part B: Vehicle Maintenance Activit„ Mnnitnrino Ranioiraman#m
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
unit
al/mo
Form SWU-247, last revised 2/2/2012
Page of if
I
Permit Number NCS S oa o 3 5 y
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
SAMPLES COLLECTED DURING CALENDAR YEAR: .7a /
(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 STAA I'E7- _rAlc
PERSON COLLECTING SAMPLES) J -d r- K ICENN E",o y COUNTY RA Ai ,004 PN
,CERTIFIED LABORATORY(S) ,vr17Aj je .,t t1Lab PHONE NO. (336 )��I2
#�,_
SIGNATURE OF PERMITTEE OR DESIGNEE
Part A: Specific Monitoring Requirements REQUIRE D ON PAGE 2.
Outfall Date 50050
No. Sample Total Total
Collected Flow if a Rainfall P 14
mo/dd/ r MG 'S
inc
A — ._ 1— __77-11___hes S. U.
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)
vuzzall Date 50050 00556
No. Sample Total Flow Total 00530 00400
Collected (if applicable) Rainfall Uf $& cease Non -polar Total pH New Moti
( pp) 0&G) PHSuspended 011 Usage
(Method 1664 Solids
SGT -HEM); if
Form SWU-247, lost revised 2/2/2012
• Page 3 of I
STORM EVENT CHARACTERISTICS:
Date!O - / - /y
Total Event Precipitation (inches): 0, } q
Event Duration (hours): 1. O (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."
/l-
(Signature of Permittee) (Date)
Form SWU-247, last revised 2/2/2012
Page,q of It