HomeMy WebLinkAboutNCS000222_MONITORING INFO_20180730STORM INATER'-DIVISION-CODfNG-SHEET
PERMIT NO.
�\CS 060aal
DOC TYPE
❑FINAL PERMIT
N' MONITORING INFO
❑ APPLICATION
❑ COMPLIANCE
❑ OTHER
DOC DATE
❑ �-Urz 0'1 3 v
YYYYMMDD
Permit Number NCS 000222
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
SAMPLES COLLECTED DURING CALENDAR YEAR: 2018
(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 Carolina Pole Leland COUNTY Brunswick
PERSON COLLECTING SAMPLE(S) Mike Rouse PHONE NO. 9( 10 ) 371-3131
CERTIFIED LABORATORY(S) Shealy Env Services Lab # 329
JUL 3���� REQUIRED ON PAGE 2.
SIGNATURE OF PERMITTEE OR DESIGNEE
Part A: Specific Monitoring Requirements CEN f ftN FlLr--1;
Outfall
No.
Date
Sample
Collected
50050
m /L
m t, "' `
m IL
m IL
m /L
m IL
Total
Flow if a
Total
Rainfalls
Pentachloroph
Phenol
Benzene
Toluene
Napthalene
Anthracene
mo/dd/ r
MG
inches
mq/L
mq/L
mq/L
mq/L
mq/L
mq/L
01
6/27/2018
0.340
0.57
<0.020
0.022
<0.005
<0.005
<0.0008
<0.0008
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Dyes Ono
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total
Rainfall
Oil & Grease
(if appl.)
Non -polar
O&G/TPH
(Method 1664
SGT-HEM), if
appl.
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/ddl r
MG
inches
m
m
unit
gallmo
01
6/27/2018
0,340
0.57
<5.7
26
7.3
62
Form SWU-247, last revised 611212015
Page 1 of 2
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS 000222
FACILITY NAME Carolina Pale Leland
PERSON COLLECTING SAMPLE(S) Mike Rouse
CERTIFIED LABORATORY(S) Shealy Env Services Lab # 329
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 2018
(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.)
COUNTY Brunswick
PHONE NO. 9( 10 ) 371-3131
ERE0
ATURE OF PERMITTEE OR DESIGNEE
UIRED ON PAGE 2.
Outfall
No.
Date
Sample
Collected
50050
m IL
m IL
m IL
m IL
m IL
m IL
Total
Flow if a
Total
Rainfall
total Ammonia
Arsenic
Copper
Chromium
Zinc
B0135
mo/dd/ r
MG
inches
mglL
mq/L
mglL
mq/L
mglL
mglL
01
6/27/2018
0.340
0.57
<0.1
0.14
0.023
0.03
<0.02
2.2
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? (Dyes Ono
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total
Rainfall
Oil & Grease
(if appl.)
Non -polar
O&GITPH
(Method 1664
SGT-HEM), if
appl.
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/ddl r
MG
inches
m
Me
unit
al/mo
Form SWU-247, last revised 611212015
Page i of 2
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS 000222
FACILITY NAME Carolina Pole Leland
PERSON COLLECTING SAMPLES) Mike Rouse
CERTIFIED LABORATORY(S) Shealy Env Services Lab # 329
Lab #
Part A. Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 2018
(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.)
COUNTY Brunswick
PHONE NO. 9( 10 ) 371-3131
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Outfan
No.
Date
Sample
Collected
50050
m IL
m /L
m /L
m IL
m /L
m IL
Total
Flow if a
Total
Rainfall
COD
TSS
Xylenes
Oil & Grease
Phosphorous
TKN
mo/dd/ r
MG
inches
mq/L
mq/L
mq/L
mq/L
mq/L
mq/L
01
6/27/2018
0.34
0.57
80
26
<0.005
<5.7
0.14
0.85
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month'?,Dyes Ono
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity MonitoringRe uirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total
Rainfall
Oil & Grease
(if appl.)
Non -polar
O&GITPH
(Method 1664
SGT-HEM), if
appl.
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/dd/ r
MG
inches
m
m
unit
al/mo
Form SWU-247, lust reaised 611212015
Page 1 of 2
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS 000222
FACILITY NAME Carolina Pole Leland
PERSON COLLECTING SAMPLE(S) Mike Rouse
CERTIFIED LABORATORY(S) Shealy Env Services Lab # 329
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 2018
(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.)
COUNTY Brunswick
PHONE NO. 9(_10 ) 371-3131
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Date
Sample
Collected
:��
•:
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? dyes Ono
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total
Rainfall
Oil & Grease
(if appl.)
Non -polar
O&G/TPH
(Method 1664
SGT-HEM), if
appl.
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/dd/ r
MG
inches
m
MRA
unit
al/mo
Form SWU-247, last revised 611212015
Page I of 2
STORM EVENT CHARACTERISTICS:
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable— see permit.)
Mail Original and one copy to:
Division of Energy Mineral and Land Rcsources
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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 owledge and belief true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
inclu g th possibility of fyneAnd imprisonment for knowing violations."
of Permittee)
7 /24/2018
(Date)
Form SWU-247, last revised 611212015
Page 2 of 2
-A
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NCS _0 C-24D SOda _ _ or SAMPLES COLLECTED DURING CALENDAR YEAR: .04)1 ?
Certificate of Coverage Number: NCG (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�QDA 1 rl0. Pllj COUNTY aWnSLQ1(_L_
PERSON COLLECTING SAMPLE(S) / PHONE NO. O
CERTIFIED LABORATORY(S) Lab # V _Lj
Lab #
Part A: Specific Monitoring Requirements
CENTRAL FILES
DWR SECTION
(SIGNATURE OF PERMITTEE OR DESIGNEE)
By this signature, I certify that this report is accurate
complete to the best of my knowledge.
Date
Sample1 Collected
►i i
��
Flow (if app.)
r
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?— yes —no
(if yes, complete Part 13)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
OOS30
00400
Total Flow
(if applicable)
TotalfttQall
Oil & Grease
Total
Suspended
Solids
pH
New Motor Oil
Usage
mo/dd/ r
I MG
Linches
mzft
mo
I Units
I eaurno
Form SWU-246-1 12608
p._4% ..e! of
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NCS-S;��. _ _ or
Certificate of Coverage Number: NCG
FACILITY NAME A 1Y"A� Q-
PERSON COLLECTING SAMPLES 2�
CERTIFIED LABORATORY(S) S iJ Lab #cS a.9
Lab # �}S l
Part A. Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 01-1
(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.)
COUNTY ZJWY`6LA]ICV
PHONE NO. 8 _O)
(SIGNATURE OF PERMITfEE OR DESIGNEE)
By this signature, I certify that this report is accurate
complete to the best of my knowledge.
1 1:
1Sample
DateI
Collected
t 1
Flow (if app.)
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
No.
Date
Sample
Collected
50050
1
00556
00530
00400
Total Flow
(if applicable)
Total Rainfall
Oil & Grease
Total
Suspended
Solids
pH
New Motor Oil
Usage
mo/dd/ r
MG
I inches
mgA
I Units
gavino
Fornn S W U-246-1 l 2608
D. , -All
STORMWATER DISCHARGE OU'1FALL (SDO)
MONITORING REPORT
Permit Number: NCS ?aaor
Certificate of Coverage Number: NCG
"-"FACILITY NAME �
PERSON COLLECTING SAMPLE(S) 1
CERTIFIED LABORATORY(S) Lab #
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: �� 1
(This monitoring report shall be received by the Division no lat than 30 days from
the date the facility receives the sampling results from the laboratory.)
COUNTY t
PHONE NO. icit
(SIGNATURE OF PERMITTEE OR DESIGNEE)
By this signature, I certify that this report is accurate
complete to the best of my knowledge.
D.
sample
Collected
ii
'Total
Flow (if appi.)
I
►
f i
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? —yes _no
(if yes, complete Part 13)
Part B- vrhirlr Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total Rainfall
OH & Grease
Total
Suspended
Solids
pH
New Motor Oil
Usage
mo/dd/ r
MG
inches
I mo
Ifflyfl-Units
al/mo
Form S W U-246-1 12608
P:'.P\ -f. � )
STORM EVENT CHARACTERISTICS:
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see pernut.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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
0 owledge and belief, tru , accurate, and complete. I am aware that there are significant penalties for submitting false information,
ificlud g the possibility of and 'imprisonment for knowing violations."
(Sign re of PermW ee) V V (D e)
Form SWU-246-112608
STORMWATF.R DISCI IARGF OUTFAI .1, 1 SDO)
MONITORING REPORT
Permit Number: NCS or SAMPLE-S COLLECTED DURING CALENDAR YEAR:
Certificate of Coverage Number: NCG ('Phis moniloring report shall be received by the Division no later than 30 days from
ll 1 ec 0 fc
I1 he facility receives (lie results from the laboratory.)
FACIL
ITY Nt1fVl1}i2 �" ECCI V COUNTY l CY
PERSON COLLECTING SAMPLE S �OCT 2 2 015 PHONE? NC). (ClI —
CERTIFITA) LARORATORY(S) U Lab
L:its # TRAL FILES (SIGNATURE OF PERMI'TTEE, OR DESIGNEE) �l
DWR SECTION By this signature, I certify that this report is accurate
complete to the best of my knowledge.
Part A: Specific Monitoring; Requirements
t
Totalo
map
wan
r
hoes this facility perform Vehicle Maifitenance Aciivitles usiiig more than 55 gallons of new tnowr oil per month? _yes \nn
(il'yes, c[unplete Port B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00555
00530
00400
Total Flow
(if applicable)
Total Rainfall
Oil & Grease
Total
Suspended
Solids
pH
New Motor Oil
Usage
mo/dd/vr
MG
I inches
m
m
Units
►al/mo
Form SwU-246- t l 2608
Page I Af
S`I`ORMWATF.R DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NCS CKDO aAa or
Certificate or Coverage Number: NCG
FACILITY NAA11. 2��� �Q.- O
PERSON COLLECTING SAMPLF{S)
CERTIFIED E,ABUI?A'rORY1S) Lab #
lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLEXTF.D DURING CALENDAR YEAR: _
('Phis monitoring report shall be received by the Division no later Ili -an 30 days from
the date the facility receive the sampling results from the laboratory.)
COUNT - LU n% )wI C_
PHONE NO. (UD) =1- 3
(SIGNATURE Oi+ P1,,RMl'r'I'EE OR DESIGNEE)
Iiy this signature. I certify that this report is accurate
complete to the best of my knowledge.
CollectedSample
1app.)Mi.
♦ /
A 1�
♦ p.
�i
1 1
KWOMMInan
r
I]oes this facility perform Vehicle Maintenance /lctiviiies using more ilian 55 gallons of new motor oil per nitwih? _ ves\- no
6f yeti. aunplete fart B)
Part W. Vehicle Maintenance Acdvity Monitoring Requirements
Outrall
No.
Date
Sample
50051)
00556
00530
004410
Total Flow
Ofapplicable)
Tota fall
Oil & Grease
Total
Suspended Solids
pH
saCollected
ffNewMotor:01T1—
mo/dd/yr
N4G
inchesm
m
Units
Form SWU-246-112008
Pagel�nf\ L,
STORMWATER DISCIIARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NCS �q or
Certificate of Coverage Number: NCG
FACILITY NAME �®
PERSON COLLECTING SAMPLF00r)NIILE
CERTIFIED LABORATORY(S) Lab #
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR:
(This monitoring report Shull he received by file Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
C()UN'CYMjjjZLC!)i�—k
PHONE NO. t
(SIGNATURE OF PERMIT'f'EE OR DESIGNEE)
fly this signature, I certify that this report is accurate
complete to the best of my'knowledle.
Date
Sample
Collected
-
.—
—
3 '
4 � �
Does this facility pertOnn Vehicle Maintemmce Autivitles using more flian 55 gal oos of new motor oil per oton[h? _ yeti�no
(if' yes, cumhlete f :trt 13 )
Part Ii: Vehicle Maintenance Activity Monitoring Requirements
Outrall
No.
Date
Sample
Collected
50051)
(10556
00530
00400
Total Flow
(if applicable)
Total Rainfa
it & Crease
Total
Suspended
Solids
pH
New Motor Oil
Usage
mo/dd/ r
MG
inches
m I
nt
Units
al/mo
Nunn SWU-246-112008
Page -or � ji
STORM EVENT CHARACTERISTICS -
Date
Total Event Precipitation (inch
Invent Duration (hours):
Of more than uric storm evcm Wus s:n
rly it a11plicable — sce permit.)
Dale
Total Event Precipitation (inches):
Event Duration (hours): (only il'al'llicahle—.,Lc permit,)
Mail Original and one copy to:
Division of Water- Quality
Mai: Central Files
1617 Mail Service Center
Raleigh, Noah Carolina 27699-1617
„I cerlify, under penally of law, that this document and all attaclunents were prepared tinder my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. fused ou 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
o tv nowledge and bet et', true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
tcludi tI; thr possibilit ' ljnes and imprisonment for knowing violations." _
� 1
igna�rre of 1'ermitteet V T (Da
Form S W u-2 (b- l r 2609
Pagel (A..
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NCS or SAMPLES COLLECTED DURING CALENDAR YEAR ON S
Certificate of Coverage Number: NCG (This monitoring report shall be received by the Division no later than 30 days from
1 the date the facility receives the sampling results from the laboratory.)
FACILITY NAME l y ► � e L COUNTY eUr6lei
PERSON COLLECTING SAMPLE(S- PHONE NO. (°I l 01 IT-
CERTIFIED LABORATORY(S) Ld Lab#<3�CEI� V rEUt�
Lab #
Part A: Specific Monitoring Requirements
ocT 07 2015
CENTRAL FILES
(SIGNATURE OF PERMITTEE OR DESIGNEE)
By this signature, I certify that this report is accurate
complete to the best of my knowledge.
rimtm
�I
Date
sample
Collected
rJuW k" app.)
i
r
r
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? — yesX.-no
(if yes, complete Parr B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total Rainfall
Oil & Grease
Total
Suspended
S4uds
pH
New Motor Oil
Usage
mo/dd/ r
IMG
I inches
MWI
m
Units
al/mo
Form S W U-246-112608
Pave I nO? d
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NCS C :�_ — _ or
Certificate of Coverage Number: NCG
FACILITY NAME (:b-2SA 1 n 0- pol Q_
PERSON COLLECTING SAMPLE(S) _
CERTIFIED LABORATORY(S) Lab #
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR:
(This monitoring report shall be received by the Division no later than 30 days from
the date the facility receive,the sampling results from the laboratory.)
COUNTY W f)SLO I (
PHONE NO. o ! - 131
(SIGNATURE OF PERMITTEE OR DESIGNEE)
By this signature, I certify that this report is accurate
complete to the best of my knowledge.
Date
Sample:
Collected
Flow (if
app.),...
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 Monito ing Re uirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
To Rainfall
Oil & Grease
Total
Suspended
Solids
pH
New Motor Oil
Usage
mo/ddiyr
MG
Inches
m
me
Units
gallmo
Form S W U-2a6-1 12608
pau.-A'6 _ 9 t/
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NCS C�-- or
Certificate of Coverage Number: NCG
FACILITY NA -ME Tl�
M1p" IX-0"
PERSON COLLECTING SAMPLE(S) tell 1
CERTIFIED LABORATORY(S) Lab #
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR:
(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.)
� `IW WUAIlrIN-AIM EN
i
(SIGNATURE OF PERMITTEE OR DESIGNEE)
By this signature, I certify that this report is accurate
complete to the best of my knowledge.
DateII
Sample
Collected :Flow
1
Total
(Irapp.)
0
1 1
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ^ yes Ono
(if yes, complete Part B)
Part 13: Vehicle Maintenance Activitv Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
otal Rainfall
Oil & Grease
Total
Suspended
Solids
pH
New Motor Oil
Usage
mo/ddt r
MG
inches
man
I Units
al/mo
Form S W U-246-1 12608
P;tee\ of N J1
STORM EVENT CHARACTERISTICS:
'Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
(if more than one storm event was sampled)
Da to
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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 who manage the sys , or those persons directly responsible for gathering the information, the information submitted is, to the best
of my kn wledge and belief, gtrl accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of f nd imprisonment for knowing violations."
of Permittee)
(Date)
Form S W U-246-1 12608
o....-" _.*,
Permit Number NCS ccoskra Ca
FACILITY NAME ca-1'riA 1-01Q—
PERSON COLLECTING SAMPLE(S) ry-1 V
CERTIFIED LAHORATORY(S)
Part A: Specific Monitoring Requirements
9 lopy
STORMWATER DISCHARGE OUTFALL;{S11 ",
MONITORING REPORT U Lim
Lab #
Lab #
SAMPLES COLLECTED DURING CALENDAR YEAR: c�'�i
(This monitoring report shall be received by the Division no later than 30 days from
the date the4acility receives the sampling results from the laboratory.)
"r CNTY ►�SLJ 1
f/PHONE NO. (910) 3 I - :SIZ1
f/ SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
4
Date
Sample
Collected
I
o
-Rainfall
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
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total
Rainfall
Oil & Grease
(if appl.)
Non -polar
O&GITPH
(Method 1664
SGT-HEM), if
appl.
Total
Suspended
Solids
pH
New Motor
Oil Usage
m Idd/ r
MG
inches
m I
MgA
unit
galifflo
Form SWU-247, last revised 21212012
Page 1 of5
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS 000;"Q —
FACILITY NAME CJ::1,Q4::A Z" � � LEA
PERSON COLLECTING SAMPLE(S)
CERTIFIED LABORATORV(S) Lab #
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: W"
(This monitoring report shall be received by the Division no later than 30 days from
the date the facilit receives the sampling results from the laboratory.)
COUNTY t+�� W 1 jc
PfIONE NO. L�
SIGNATUI; E OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
iSampleCollected
Date
II I
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per nionih? _yes _no
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
rota
Rainfall
Oil & Grease
(if appl.)
Nan -polar
O&G/TPH
(Method 1664
SGT-HEM), if
1.
Total
Suspended
Solids
pH
New Motor
Oil Usage
moldd/Yr
MG
inches
m I
mg/1
unit
al/mo
Form SWU-247, last revised 21212012
1'agA of'195
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS Qa
FACILITY NAME C. rasp} 1 ihA
PERSON COLLECTING SAMPLE(S)
CERTIFIED LABORATORY(S) Lab €i
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: QP1
('rhis 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.)
COUNTY 8 &A h I.J
PHONE NO. L__)
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
MCollected
Sample
Total
1 ,
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes Ono
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring lktluiremenis
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total
Rainfall
Oil & Grease
(if appl.)
Non -polar
O&GITPH
(Method 1664
SGT41EM),,if
appl.
Total
Suspended
Solids
pH
New Motor
Oil Usage
moldd/vr
MG
inches
m I
m /l
unit
al/mo
Form SWU-247, last revised 21212012
Pagc5 0fS
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS OC>O �iar-),
FACILITY NAME ...CQkA2.,� 1p1 ��`
PERSON COLLECTING SAMPLE(S)
CERTIFIED LABORATORV(S) Lab #
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR:
(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.)
COUNTY 1(J►SDLt�
PHONE NO. �}
SIGNATURE OF PERMITT'EE OR DESIGNEE
RFQUIRED ON PAGE 2.
1
Date
Sample,
Collected
II I
1
Rainfall
.,.r ...
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 Monitorine Requirements
Out -fall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total
Rainfall
Oil & Grease
L)
Non -polar
O&G/TPH
(Method 1664
SGT-HEM), if
a
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/dd/vr
MG
inches
mg/1
m /l
unit
al/mo
Form SWU-247, last revised 21212012
Pagc14
STORM EVENT CHARACTERISTICS:
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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 beliefI'd
ue, accurate, and complete. I am aware that there are significant penalties for submitting false information,
incl i.n the possibility of figr� imprisonment for knowing violations."
of Permittee)
(Da e)
Form S WU-247, last revised 2/2/20I
i'agof
Permit Number: NCS q)QE�.oiG6;k - - - fir
Certificate (it' Coverage Number: NCG
STORMWATF.R DISCHARGF OUTFA1.1.(SDo)
MONITORING REPORT
SAMPlYS COLLECITI) DURING CALENDAR YEAR:A0 L5
('this monitoring report shall he received by the Division no later than 30 days from
the date the facility receives tthheessampling results front the luhoratory.l
I�ACU I'TY NANII. 1 >12 COUNTY �.�t2t�r)Sy_l
PF?RtiON COLLECTING SAMPLE(S) Qr -R E I V ED 11IIONF NOw (q-
CERTIF ED I.ABORATORY(S) 5 >J Lab
I.ah ft� 1 5 2015
Part A: Specific Monitorial; Requirements
CENTRAL FILES
DWR SECTION
(SIGNATURE OF PE MI'1"!'EE OR DESIGNFFI
By this signature, ) certify that this report is accurate
complete to the hest of my knowledge.
7Mn,
Date — — 1���
Sample I
Collected
-
-
hues this (acility herl'urin Vehicle Maintenance Activities using nhore than 55 gallons of new iuntor nil per hrtunth'! _ yes _no
(if yc,s, coniplele )'art B)
Part W Vehicle Maintenance Activity Monitoring Requirements
Outf'all
No.
Date
Sample
Collected
541050
110556
00530
00400
Total now
(if applicable)
'Total Rainfall
Oil & Grease
'Total
Suspended
Solids
pH
New Motor Oil
Usage
mo/dd/vr
I AiG
I inches
m
m o
Units
ga11mo
Boron SWU-240-1 t2008
P'ige 1 ul'Vi
Permit Number: NCS Q QQ 9&a . or
Certificate of Coverage Number: NCG
FACILITY NANIF C—Q—QZA } y)a'PPl q--
PERSON COLLFCTI,NG SAMPI-F S)
CERTIFIED LABORATORV(S)
Purl A: Specific Monitoring Requirements
STORMWATER DISCHARGE OUTFAI.L (SDO)
MONITORING REPORT
LeQ�
.ub #
.uh #
SAMPLES COLLECTED DURING CALENDAR YEAR:
('Phis monitoring report shall be received by the Division no later than 30 days from
the (late (lie t'acility receive, the sampling results from the laboratory.)
COUNTY ZunsLkil C
PHONE NO. ( O ) j
VSIGNATURE OF PERM 17"1 EE OR
By this signature, I certify that this report is accurate
complete to the hest of my knowledge.
Sample
Collected
.. �.
a
r
Does this facility perform Vehicle Maintenance Activities using morn thin 55 gallons of new motor oil per mmith7 _ yes _no
(ifycs. complete I'art li)
Part It: Vehicle Maintenance Activity Mortitorin); Requirements
Outfull
No.
Date
Sample
Collected
50U5c1
00556
00530
00400
Total Flow
(if applicable)
Tota fall
Oil & Grease
Total
Suspended
Solids
PIS
New Motor Oil
Usage
mo/dd/vr
I MG linches
mg/I
m
Units
al/mo
Moroi SWU- 46-1 1 008
l,g4cI%ol''x 1�
S'TORMWATER DISCIIA RGE. OUTFALL (SDO)
' MONITORING REPORT
Permit Number: NCS_ noES;A ^ or SAMPLES COLLECI'EI) DURING CALENDAR YEAR:
Certificate of Coverage Number: NCG (Phis 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 NAiINIE PC)e+ COUNTY t CIL
PERSON COLLECTING SAMPLE(S) } PHONF NO. (cl I�
CEWrIFII:1) LABORATORY(S) Lab #
Lab #, (SIGNATURE OF PERMITFEE OR DESIGNEE)
By this .signature, I certify that this report is accurate
complete to the best of my knowledge.
Part A: Specific 11lonitoring Requirements
0
r
Dues this facility perform Vehicle Maintenance Activities Using more than 55 gallons of new motor oil per month?- yes _nn
(il yeti, euniplete Part 13)
]'art B: Vehicle Maintenance Activity Monitoring Requirements
Outrall
No.
Date
Sample
Collected
(10556
00530 1
00400
'Total Flow
(if applicable)
tal Rainfall
Oil & (;reuse
Total
Suspended
Solids
pH
New Motor Oil
Usage
nu>/dd/vr
NIG
inches
m 1
nio
Units
►aumo
Form SWII-246-112608
I'u� �4>I � .4
S'f'ORn EVENT OIARACTFRISTICS:
Date
Total Event Precipitation (inches):
Event Duration (hours): (only ii' applicable — see permit.)
(i1' more tluin mic storm event was sampled)
Date
Total F;vent Precipitation (inches):
Event Duration (hours): (curly if applicable; — see hermit.)
Mail Original and one copy to;
Division of Water Quality
Attm: Central Files
1617 Mail Service Center
Raleigh, North Curo ina 27699-1617
"I certify, under penalty cif law, that this document and all attachment% 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. Rased ou 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 y k iwledge and belief, lr accurate, and complete. I am aware that there are significant penalties for submitting false information,
i lading lte possibility of fin . mprisonment for knowing v'o • ions."
(Sign ur of Permittee) (Date
t'orj SWt1-?=lei-t 12608 P:t9c1e,�OIN f e Lf
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NCS ar
Certificate of Coverage Ni niher: NCC;
FACILITY NAME 11 1 e
PERSON COLLECTING SAMPLE(S � Q
CERTIFIED I.ABORATORY(S1 5 U Lab#SQA
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: �
(This monitoring report shall be received by the Division no later Ihau 30 days from
the date the facility receives
�the sampling results from the laboratory.)
COUNT)' Zzur'6 1 ��
P[ NO. Cz
RECEIVE t9W'WIR E I i I+ PERMEI""PE ORDESIGNEE)
JAN 121 2015B ns signature, I certify that this report is accurate
c lete to the bell of my knowledge.
p.
CENTRAL FILES
nlA10 Crri`TInAI
salliple
Collected
— - -
-
- --
rop
NEW
I
I�
Does [his facility perform Vehicle Maii►[em ice Activities using more than 55 gallons of new motor oil per month? _ yes \ no
(ifycs, complete Part B)
Part li: Vehicle Maintenance Activity Nionilurin g Rer uirenivias
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00406
Total Flow
(if applicable)
Total Rainfall
Oil & Grease
Total
Suspended
Solids
PHNew
Motor Oil
Usage
nor/
Irlf r
MG
inches
ingfil
mg./I
Ui its
►al/m
lLeI
9
f-�onn SWLI- 40-1 1 008
Pagc I oF�li
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NCS Q (DO
Certificate of Coverage Number: NCG
l ACILITY NAME T
L�
PERSON COLLECTING SAMPLES)
CERTIFIEII LABORATORY(S)
Lab #
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: a017
('Phis monitoring report shall be received by file Division no lister (hall 30 days from
the (lute the facility receive' the sampling; results from the laboratory.)
COUNTY � n
I r1rE,NO. O �j•
(. A'1'URE (, PERMI'I-I'EE OR DESIGNEI�1
By leis signature, I certify that this report is accurate
cot plete to the best of my knowledge.
Date
Sample
Collected
4
MOM
Does this facility perform Vehicle Maintenance Activities using nn)re than 55 gallons of new motor oil per month?_ yes _110
f i f yes, complete Part 13 )
Part 13: Vehicle lilaintenanee A etivity Nionito ing Requirements
Outfall
No.
Date
Sample
Collected
50m
00556
00530
00400
Total Flow
Hf applicable)
Tota n€all
Oil & Grease
Total
Suspended
Solids
pH
New Motor Oil
Usage
ino/dd/yr
Mf,
inches
m
m ll
I Units
■al/mo
Forni S W U-2-th-1 12008
1';tge�ul �
STORMWATER DISCHARGE OUTI+ALL (SDO)
MONITORING REPORT
Permit Number: NCSC).Q�S&or
Certificate of Coverage Number: NCG
FACILITY NAME PO Q,
PERSON COLLECTING SAMPLE(S) 1
CERTIFIED LABORATORY(S) Lab#
Lab #
Part A: Specific Moniloring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR:
1'I'his monitorial; report shall be received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.!
(SIG TURF OF PERMITI'EE OR DESIGNEE)
ByV11,itsignature, I certify that this report is accurate
col e to the hest or my knowledge.
1Date
Sample
Collected
m
4
Does this facility het firrrn Vehicle Maimenarrce Activities using more than 55 gallons of iiew motor oil per month? _yes _uo
(if y(:S, complete Pan B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
011556
00530
00401)
Total Flow
drapplicable)
Total Rainfall
Oil & Grease
Total
Suspended
Solids
pH
New Motor Oil
Usage
mohld/ r
MG j
inches
nio
I ur
Units
al/nso
Nunn S W LI-240-1 1 008
Page3uA f ji
S'1'014M EVEN'r CIIARACTF?[tIS'r]C:S:
Date
Total li:vcut ecipitation (inches):
Event Duration ours):
(only if applicable -- see pernvt.)
of more thou one stun evi:nt was sample)
Date
Total Event Precipitation 0 ches):
Event Duration (hours): _ (only it applicable — are permit.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central files
1617 Mail Service Centel -
Raleigh, North Carolina 27699-1617
"I certify, under penalty of law, [hill this document and all atlachments were prepared under my direction or supervision in accorduuce with it
system designed to assure that qualified personnel properly bather and evaluate the information submitted. [lased on my inquiry of the person
or persons who manage the system, or those persons directly responsible ror ga[hering; the information, the information submitted is, to the best
of my knowledge mid belief, true, accurate, and complete. I am aware that there are significant penalties ror submitting false information,
includi he possibility of limes and imprisonment for knowing; violations."
fSig t re of 1'ermittee { te)
Form SWU-2 40-1 I2WS
Pagev'sj,
.+-
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NCS_ or
Certificate of Coverage Number: NCG
FACILITY NAME 1 �1 Z
PERSON COLLECTING SAMPLE(S) Q
CERTIFFED LABORATORY(S) S Q Lab #SQAa9
Lab # -±}81
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: qgl�
(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.)
COUNTY d.)IZUr)6
PHONE NO. (°l� L O)
TURFOF PERMITTEE OR DESIGNEE)
signature, I certify that this report is accurate
e to the best of my knowledge.
DateII
Sample
Collected '.Flow
I
a —I
(if app.)
lop
1iY 7Yti
iDWO/BOG-
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 Monito ing Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total'Flow
(if applicable)
Total Rainfall
Oil & Grease
Total
Suspended
Solids
pH
New Motor Oil
Usage
mo/d .r
MG
inches
MRA
I mall
Units
al/mo
AVO&r~
-�
RECEIVED
AUG 0 7 2914
CENTRAL FILES
DWQ/B0G
14q
R�UP t -4*%
Form S W U-2�+6- 1126(}fl
Li
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NCS C DQ or
Certificate of Coverage Number: NCG
FACILITY NAME COLA-C)l 1 Yl Q' 100l Q--
PERSON COLLECTING SAMPLE(S)
CERTIFIED LABORATORY(S) Lab #
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: &01
(This monitoring report shall be received by the Division no later than 30 days from
the date the facility receive sampling results from the laboratory.)
COUNTY d:5ZUn)L I C.
PHONE NO. 10-1 A—)1-
(FOC ATURE OF PERMITTEE.OR DESIGNEE)
BUthis signature, I certify that this report is accurate
complete to the best of my knowledge.
SampleI
Collected
Flow
1
• r.•
+
t
�_
1 1 1 1
_
1 -.
�■
i
'r
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
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
To all
Oil & Grease
Total
Suspended
Solids
pH
New Motor Oil
Usage
mo/dd/ r
MG
inches
nWA
mo
units
al/mo
Form S W U-246-1 12608
t>n a^ -f 4 It
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NCS a or
Certificate of Coverage Number: NCG
FACILITY NAME n X�®
PERSON COLLECTING SAMPLE(S) VnIke- -QUA
CERTIFIED LABORATORY(S) Lab #
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR:
(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.)
COUNTY t
PHONE NO. (�Cg
(SIGNATURE OF PERMITTEE OR DESIGNEE)
By this signature, I certify that this report is accurate
complete to the best of my knowledge.
•
D:
Sample
Collected
rt t
_
oil
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 Monito ing Requirements
Outfall
No.
Date 150050
Sample
Collected
00555
00530
00400
Total Flow
(if applicable)
Total Rainfall
Oil & Grease
Total
Suspended
Solids
pH
New Motor OF
Usage
mo/dd/ r
MG
inches
m
Units
athno
3`
Form S W U-246-1 12608
Pa 17A of N 11
STORM EVENT CHARACTERISTICS:
Date
Total Event Precipitation (inches):
Event Duration (hours):
(only if applicable — see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — sec permit.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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,
in the possibility of fi and imprisonment for knowing violations."
• it
tTe of Permitlee) (D e)
Form SWU-246-112608
h_ - A-