HomeMy WebLinkAboutNCS000140 DMR SWSTORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NCS DDO / `i 1] or
Certificate of Coverage Number: NCG
FACILITY NAME L e—CA e d
PERSON COLLECTING SAMPLE(S) --fir
CERTIFIED LABORATORY(S) .M2 I +e �-� ,(1C. Lab #
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: Z�r�
(This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives th�sampling re ults from the laboratory.)
COUNTY v
PHONE NO. (
(SIG)*WO OR DESIGNEE)
By dris signature, I certify that this report is accurate
complete to the best of my knowledge.
Outfall Date
No. iple
I'Collected
To
Flow
ON, M'
00530
00400
MA
Oil and
Grease
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/dd/ r
MG
m /l
mg/l
unit
al/mo
aII� 'r 1W,
a
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes A no
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall Date
No. Sample
Collected
50050
00556
00530
00400
Total Flow
Oil and
Grease
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/dd/ r
MG
m /l
mg/l
unit
al/mo
Form SWU-246-051100
Page 1 of 2
A
STORM EVENT CHARACTERISTICS:
Date 3 3° �� I
Total Event Precipitation (inches): i
Event Duration (hours): 3
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours):
L
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 er o s directly responsible for gathering the information, the information submitted is, to the best
of my knowledge and belief, true, acc7urate, n co plete. I am aware that there are significant penalties for submitting false information,
including the possib' 'ty off ris n ent for knowing violations."
Zill
(Signa a of Permittee) ate
Form SWU-246-051100
Page 2 of 2