NCS000321 DMR SW (8)

PERMIT COVERAGE NO. NCS0000321
FACILITY NAME Lubrizol -Gastonia
PERSON COLLECTING SAMPLE(S)
CERTIFIED LABORATORY(S) Prism Labs
Part A: Specific Monitoriug Requirements
STORMWATERgj=LL (SDO)
ANALYTIC ORT
Smith
Lab #
NUV 18 2015
CENTRAL FILES
DWR SECTION
Outfall
No.
Date
Sample
Collected
Total Biochemical
Flow Oxygen
Demand
Total
Suspended
Solids
Chemical Z nc pH
Oxygen
Demand
mm/dd/ r MG m m
m m
02
7/22/2015
14
90
140 0.31 9
Lead, Total
Detergents
pH
New Motor Oil
Collected
mm/dd/
MG
m
Recoverable'
u
(MBAS)`
m
unit
Usage
al/mo
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 uo later
than 30 days from the date the facility receives the sampling results)
COUNTY Gaston
PHONE NO. 19 749 54165
(SIGNATURE OF PERMITTEE OR DESIGNEE)
By this signature, I certify that this report is accurate
complete to the best of my knowledge
Outfall
Date
50050
00556
01051
38260
00400
No.
Sample
Total Flow
Oil and Grease
Lead, Total
Detergents
pH
New Motor Oil
Collected
mm/dd/
MG
m
Recoverable'
u
(MBAS)`
m
unit
Usage
al/mo
STORM EVENT CHARACTERISTICS
Date 7/20/2015
Total Event Precipitation (inches):
Event Duration (hours): 4
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours):
0.51
Yes X No
Attn: Central Piles
DEHNR
Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
Form MR18
Page 1 of 2

Footnotes:
' Applies only for facilities at which fueling occurs.
2 Detergent monitoring is required only at facilities which conduct vehicle cleaning operations.
"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)
111/3//S
(Date)
Form MR18
Page 2 of 2