NCS000508 DMR SW (18)

RECEIVED 491
MAY 052014
CENTRAL FILES
DWQIBOG
North Carolina Department of Environment and Natural Resources
To: Division of Water Resources Division of Water Resources
Attn: Central Filesannual Winston-Salem Regional Office
&°z��opy� 1617 Mail Service Center summary 585 Waughtown St.
Raleigh,NC 27699-1617 only) Winston-Salem,NC 27107
Discharge Monitoring Report
Facility Name: Piedmont Triad International Airport Permit: ilCS' 11 _1(S;
County: Guilford Phone: [phone]
Person Collecting Sample: Toby S. Benfield, ECS Carolinas, LLP
Certified Laboratory(s): Research&Analytical Laboratories,Inc. Lab #: NC#34
Lab #:
Date of Sample Collection: April 30.2014
Schedule: Year 4 (Permit 2)
Period (quarter)
Episode (deicing event)
Tier Two 5 (month)
ADF Applied (if applicable) 0 gallons on April 28,2014
O gallons on April 29,2014
O gallons on April 30,2014
Total Event Precipitation: 0 inches on April 28,2014
0.18 inches on April 29,2014
0.19 inches on April 30,2014
Qualitative and/or Quantitative Results Attached
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 knowled:e and belief,true,accurate, and complete. I am
aware that there are significant penalti-s for ub�-��'ing false information, including the possibility of
fines and impriso en 'or ,•i -/ola ' n
Signature: ice:` Date: 3 /?// 67
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