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STORMWATER DISCHARGE OUTFALL(SDO)
MONITORING REPORT 1
Permit Number rC t+ 1 SAMPLES COLLECTED DURING CALENDAR YEAR:943% `g%
(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 �\'rA C°4-A1-12-61-"c-Q. COUNTY `1.��n'So 1 c-1\
PERSON COLLECTING SAMPLE(S) nr-1,k e, L PHONE NO.MAO) ' 1 l — 31Z
CERTIFIED LABORATORY(S) Lab#
Lab#
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Part A:Specific Monitoring Requirements
Outfall ;Date
No. " � 50050 _
Total
Collected Flow(if app.)- Rainfall, . lr�rM- 5 �.. � �'
imo/dd/yr- MG . - :inches, MSS L"' - t1Res I L . t1Nt TireCt I L y -
V 6111 I Ln 0:19 Q. 5 <o.0N Go.o1 Eo. 53
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)
Part B:Vehicle Maintenance Activity Monitorin Requirements
Outfall= ' 'Date_ '5005V', "°°° . 00556, , ' ;00530`' ` 00400'
No.-i- Sample ��Total Flow Total Oil&Grease; Nonpolar" - Total pH New Motor
Collected f-� (if applicable)' Rainfall �(if apply ', :O&G/TPH ;- Suspended° -Oil Usage;_
`(Method 1664 Solids _
-
� w
"mo/dd/yr " MG ° ".inches" . . ,mg/1 mg/l - unit. - 'gal/mo
® � lo frl)J Le UP, Q.5 • IDS A
Form SWU-247,last revised 2/2/2012
Page 1 of,
STORMWATER DISCHARGE OUTFALL(SDO)
MONITORING REPORT
Permit Number NCS ,C SAMPLES COLLECTED DURING CALENDAR YEAR:o�I�
(This monitoring report shall be received by the Division no later than 30 days from!
L.d
the date the facilit receiv'ees,the sampling results from the laboratory.)
FACILITY NAME �11 YA o\-�, QAJ COUNTY�YL^ -sti W 1(,1C
PERSON COLLECTING SAMPLE(S) PHONE NO.( )
CERTIFIED LABORATORY(S) Lab#
Lab#
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Part A:Specific Monitoring Requirements
Outfall Date 50050
No. Sample Total Total71-3
'1'Ad �\ PiaA �212Rieu. „�1 \AV
Collected Flow(if app.) Rainfall 1 S P. �
mo/dd/yr - MG - inches. /-L,. 1t/L. - Yby9I-L - SAI L - ,S I L fig)L
01 Lein11b N
495 <0.005 090-11 <0.005 40.005 <0.01
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)
Part B:Vehicle Maintenance Activity Monitoring Requirements
Outfall -Date ` - - 50050, • , - , 00556 • ' ; 00530 ,- 00400 ' '
No: • Sample ,Total Flow Tota Oil&Grease• , Non-polar Total a pH, ` - New Motor
Collected (if-applicable) 'Rainfall (if appl:) " O&G/TPH" Suspended_ - Oil Usage
(Method 1664 Solids' . ` "
. . SGT-HEM),if
1.
mo/dd/yr , MG - ' inches mg/I - mg/l - - unit - gal/mo `
Form SWU-247,last revised 2/2/2012
PagAof.5
STORMWATER DISCHARGE OUTFALL(SDO) !
MONITORING REPORT ,
Permit Number NCS CO W .a SAMPLES COLLECTED DURING CALENDAR YEAR: 1
(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 C r,e,Q ),—A11 A P4CAE, 1-.40-1.-SZ COUNTY 8 a (...31 Ck
PERSON COLLECTING SAMPLE(S) PHONE NO.( )
CERTIFIED LABORATORY(S) Lab#
Lab#
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2. ,
Part A:Specific Monitoring Requirements ;
Outfall Date 50050 - •
No. Sample Total Total 'i4:St�L ' O4 '
Collected Flow(if app) Rainfall hli +rnalnlA ,�1b.�e't'1QJ0 (3 Ro�1�• `0-i: 'M i
mo/dd/yr MG inches - In I L B-1 L, b'FAJ L Ma J L '•M24)L ' Mt 1 L
®1 Ll n ilu '\ <0.0) 103 <o•o0 5 <409 O.c)11 ______ 1
0. i Ca
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)
Part B:Vehicle Maintenance Activity Monitoring ' •quirements
Outfall Date 50050 00556 ' ' 00530 ' 00400 '
No. ' Sample , Total Flow . 'Total ' Oil&Grease, =. Non-polar Total pH New•Motor
Collected (if applicable) 'Rainfall . (if appl.). O&G/TPH , Suspended Oil Usage ,
_ (Method 1664 „ ,Solids ,
SGT-HEM),if - _
• appl.,.
mo/dd/yr MG - inches " , mg/I mg/i ` - unit- ' gal/mo
Form SWU-247,last revised 2/2/2012
Page ofE
STORMWATER DISCHARGE OUTFALL(SDO)
MONITORING REPORT
Permit Number NCS O D (
`�'�,� SAMPLES COLLECTED DURING CALENDAR YEAR: )C3 I l
(This monitoring report shall be received by the Division no later than 30 days from♦
the date the facility receiveslthe sampling results from the laboratory.)
FACILITY NAME C i\ ltl A 43c7,\.‘_, L42-CIOA-R COUNTY v IR Z�\
PERSON COLLECTING SAMPLE(S) PHONE NO.( )
CERTIFIED LABORATORY(S) Lab#
Lab#
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Part A:Specific Monitoring Requirements
Outfall' Date 50050 .
No: Sample Total Total \lelit
Collected Flow(if app.) Rainfall u q ^ ueob '
, mo/dd/yr MG inc s ' ' Mob/L l tr+l-FS Ind L
OC)) G11--)) .oc.41 7.aa 1-1
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)
Part B:Vehicle Maintenance Activity Monitorin Requirements
Outfall Date 50050, 00556 , 00530 00400,
No. " Sample Total Flow Total Oil&Grease Non-polar 'Total ' pH New Motor
Collected (if applicable) `Rainfall I.) ` O&G/TPH Suspended Oil Usage r
(Method 1664 Solids
SGT-HEM),-if
mo/dd/yr MG inches mg/I
mg/1 ' 'unit' . gal/mo ,
Form SWU-247,last revised 2/2/2012
P a gegt of
STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Division of Water Quality
Date Attn:Central Files
Total Event Precipitation(inches): 1617 Mail Service Center
Event Duration(hours): (only if applicable—see permit.) Raleigh,North Carolina 27699-1617
(if more than one storm event was sampled)
Date
Total Event Precipitation(inches):
Event Duration(hours): (only if applicable—see permit.)
"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,
incl i _ the possibility of II r d imprisonment for knowing violations."
AP
i a, s- /6
(', a of Permittee) (Da e)
Form SWU-247,last revised 2/2/201
Pagcof�