NCS000388_MONITORING INFO_20160616

STORMWATER DIVISION CODING SHEET
PERMIT NO.
DOC TYPE
❑FINAL PERMIT
MONITORING INFO
0 APPLICATION
0 COMPLIANCE
❑ OTHER
DOC DATE
❑ 701(o o6I,6
YYYYMMDD

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCO080000
FACILITY NAME Jowat Corporation / C S /) vt/,3 D 9
FACILITY Addres., PO Box 1368 High Point, NC 27261
PERSON COLLECTING SAMPLE(S)
CFR`I'IFIED LABORATORY(S) R & A I-aboratoriec, Ina Lab 0 34
Lab 0
Part A: Specific Monitoring Requirements - Analytical Monitoring
SAMPLES COLLECTED DURING CALENDAR YEAR: 2016
(all samples collected during a calendar year, shall he reported no later
than January 31 of the following year)
COUNTY Randolph
PHONE NO. [phone]
(SIGNATURF.OF PFRM1171,1, OR DF,SIGNEE)
By this signature, 1 certify that this report is accurate and
complete to the best of my knowledge.
Outfall
No.
Date
Sample
Collected
50050
00545
00400
Total
Flow
Total
Suspended
Solids
pH
maldor
MG
m9/1
unit
001
05/01/16
95.0
6.25
002
05/01/16
12.5
5.36
003
05/01/16
33A
5.32
004
05/01/16
63.2
5.92
Part B: Visual Monitoring Requirements
RECEIVED
JUN 16 1016
CENTRAL FILES
DWR SECTION
Date
Floating
Suspended
Sample
Color
Odor
Clarity
Foam
Oil Sheen
Other
OutfaU
Collected
Solids
Solids
Na.
moldr
Sediment in
001
05/01/16
Clear
None
Semi -Clear
None
Yes
None
No
bottom
002
05/01/16
Clear
None
Semi -Clear
None
None
None
No
None
Sediment in
003
05/01/16
Dirty
None
Not Clear
None
Yes
None
No
bottom
Sediment in
004
05/01/16
Dirty
None
Semi -Clear
None
Yes
None
No
bottom
STORM EVENT CHARACTERISTICS:
Date 5/1/2016
Total Event Precipitation (inches): 0.52
Event Duration (hours): 2.75
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours):
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours):
Mail Original and one copy to:
Attn: Central Files
DEHNR
Division of Environmental MQt.
P.O. Sox 29535
Raleigh, NC 27626-0535
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours):
norm MR-18
Page I of 2

Footnotes
"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 inquirey 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."
(Signature of Permittee)
(Date)
Form MR-18
Page 2 of 2