NCS000321 DMR SW (12)

7
STORMWATER DISCHARGE OUTFALL (SDO)
ANALYTICAL MONITORING REPORT
PERMIT COVERAGE NO. NCS0000321
FACILITY NAME Lubrizol -Gastonia Facility
PERSON COLLECTING SAMPLE(S) Bobby Smith
CERTIFIED LABORATORY(S) Prism Labs Lab # 402
Lab #
Part A: Specific Monitoring Requirements
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
C"y
(SIGNATrRE OF PERMITTEE OR DESIGNEE)
By this signature, I certify that this report is accurate
complete to the best of my knowledge
Outfall ate
No. Sample Total Temp Temp Temp 10il & Grease pH
Collected Flow Upstream Downstream
i!
Date
50050
Chlorine
COD
m yr gar7-m l m
m
m
No.
Sample
Total Flow
02 12/11/2015 107.7 31.9 16.5 17 6.88
0.041
Detergents
pH
New Motor Oil
Collected
Recoverable'
(MBAS)`
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 Activity Monitoring Requirements
Outfall
Date
50050
00556
01051
38260
00400
No.
Sample
Total Flow
Oil and Grease
Lead, Total
Detergents
pH
New Motor Oil
Collected
Recoverable'
(MBAS)`
Usage
mm/dd/yr
MG
III mg/1
ug/1
mg/I
unit
gal/mo
STORM EVENT CHARACTERISTICS
Date
Total Event Precipitation (inches):
Event Duration (hours):
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours):
Flow of 1 inch = 107.7 gpm
SVM
JAN 12 2016
C6NTRAL FILES
Yes X No DW' SECTION
Mail Original and one copy to:
Attn: Central Files
DEHNR
Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
Form MR18
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A d
Footnotes:
' Applies only for facilities at which fueling occurs.
Z 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)
(Date)
Form MR18
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