NCG060205 DMR SW (3)

STOR De 0- a'--rn , - -GE OUTFALL(SDO) ?
' i'x: ' O -ii; 'a:REPORT –of_
GENERAL PERMIT NO. NCG060000 JUL 2015 SAMPLES COLLECTED DURING CALENDAR YEAR: i S
CERTIFICATE OF COVERAGE NQ.NGG060205
CENTRAL�(LES(This monitoring report is due at the Division no later than 30 days from
DWR SECTION the date the facility receives the sampling results from the laboratory.)
FACILITY NAME: Custom Finishers, Inc. COUNTY: Guilford
PERSON COLLECTING SAMPLES: D ENn1 I S -P2-1E1---SK) PHONE NO.: [phone]
CERTIFIED LABORATORY: Research &Analytical Lab#: NC34
PLEASE SIGN ON THE REVERSE -
Part A: Specific Monitoring Requirements
Outfall Date 00530 00400 00340 00556 31616
No. Sample Total Suspended pH, Chemical Oxygen Oil and Grease, Fecal Coliform,
Collected, Solids, Standard Units Demand, mg/L Colonies per 100 ml
mo/dd/yr mg/L mg/L
Benchmark - 100 Within 6.0 -9.0 120 30 1000
SDO2 (Via,' IC <' 5 4,0 /o Cc N/A
Note: if you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses.
See General Permit text.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month'? yes X no
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall Date 00556 00530 00400 _
No. Sample Collected, Oil and Grease, Total Suspended Solids, pH, New Motor Oil Usage,
mo/dd/yr mg/L mg/L Standard Units Annual average gal/mo
Benchmark - 30 100 6.0 -9.0 -
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses.
See General Permit text.
STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Division of Water Quality
Date (o I)-1( IS (first event sampled) " Attn: DWQ Central Files
Total Event Precipitation (inches): „ 0� 1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
SWU-249-102107
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"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."
d?// /1//5
(Signatur f Permittee (Date)
SWU-249-102107
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