NCG080878 DMR SW

STORMWATER DISCHARGE OUTFALL(SDO)
MONITORING REPORT
GENERAL PERMIT NO.NCG080000 SAMPLES COLT,FCTED DURING CALENDAR YEAR: ZDt(-
CERTIFICATE OF COVERAGE NOTING4tit (3 )`' (This monitoring report is due at the Division no later than 30 days from
L r 1.e.-
the date the facility receives the sampling minas from the laboratory.)
FACILITY NAME 1 T 2 COUNTY t U tn.�W al--
PERSON COI LE G SAMPLES Will awt 6A,1 *14-, PHONE NO.(e )D) 25.3-l t-11
CERTIFIED LABORATORY P/101/oc Gten,. Lab# ilo-li4'11
P_✓i it i1 r o c 14, a vr,- Lab#t io it soo PLEASE SIGN ON THE REVERSE 3
Part A.Vehicle Maintenance Areas Monitoring Requirements �' �,�
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? es _no iii(
(if yes,report your analytical results in the table immediately below)
it Date -0 J . :.i' _ 8 4 1i . F-4417-1Z4� - ---- --
-
4 �9a. „ Sample Collected,- Td "qt r at ►r Ala, I ' IA Oil Anil New Motor Oil Usage, v C�'OA/
. 2..J�v I_ mmol +r ... dIbc�t�a{{uniits t.nx aI E ,,l/mo
B t t„rehi it. to` to I-Z Ot lP 1,110—' Vtti;—,9,:, ., Aii37a zW J.Y
30 CO® - 3.n o
.STOP /IA -'1..3 1(.o 2 45. o
WA-jr - 6(10I2ot 6 t 1, 8 7, 1cf 4. 5.0 I i Li,
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.
sD
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals � ' i
Otit€dl ' Rabe
No, San4ple.Cvlleeted, OR � ' . total Solld . 00440 JU'- 4C) /0lb
ntkrii ' St t�ti d units Penn*Milt CEc\J
- � 1' 64.0.(1 DWR 0110
NgiA -, 1
STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Division of Water Quality
Date b t0 t to (first event sampled) Attn:DWQ Central Files
Total vent Precipitation(inches): . Jr 1617 Mail Service Center
Raleigh,North Carolina 27609-1617
Date (list each additional event sampled this reporting period,and rainfall amount)
Total Event Precipitation(inches):
SWU-250-102107
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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."
(Slut : e of Permittee) (Dat
•
SWU-250-102107
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