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Home My WebLink AboutNCG080947_MONITORING INFO_20190218PERMIT NO. DOC TYPE STORMWATER DIVISION CODING SHEET NCG PERMITS Iv LC ❑ HISTORICAL FILE -9 MONITORING REPORTS DOC DATE ❑ o"o) F YYYYMMDD `" 1 STORMWATER DISCHARGE OUTFALL (SDO) MONTTORING REPORT GENERAL PERmn No, NCGO60000 CERTIFICATE OF COVE, RACE NCGOQ%9'q77�" FACILITY NA.M); Allegq ._:/5/LL1M1 PERSON COLLECTING SAMPLES CERTIFI_CD LABORATORY Sri ! b 1 5," Lab # 2557 Lab # Part A, Specific Monitoring Requirements SANYTLES COLLRCTED DIJMG CALENDAR YEAR! (This monitoring report Is dus at the Division no later than 30 dtiys trem the date the facility receives the sum r ults fr w the laboratory.) COUNTY PHONE NOS L PLEASE SIGN ON THE REVERSE -> RECEIVED uutfall Date 00530 00400 00340 00556 No. Sample Total Suspended pH, Chemical Oxygen Oil and Grease, Collected, Solids, Standard units Demand, mg/L moldd! r m m Benchmark - 100 Within 6,0 — 9.0 120 30 !h 2 ozs Note; Iryou report in, same iod value In excess of the benchmark va us, or outside the benchmark range for pH, you must lament Sea General Permit text, Did this raollity perform Vehicle Maintenance Activities using more than 55 gallons of now motor oil per month? yes _no (if yes, complete Part B) Part B; Vehicle Maintenance ActivityMonitorin Re uirements Outfall Date 00556 00530 00400 No, Sample Collected, 00 and Grease, Total Suspended Solids, pH, oldd/ r tnWL m Standard units Ben hmark 30 100 6.0-9.0 31616 Fecal Coliform, Colonies per 100 ml 1000 I or'Tlor•2responses, New m Annual Note; if you report a samp ed value In excess of the be limark value, or outside the benchmark range for p , you must Implement Tier I or Tier 2 responses, See General Perrnit iext. STORM EVENT CHA.RACTERTSTICS; Hall Original and one copy to; Division or Wator Qual Ity Date/_ (first event sampled) fJ Mtn, DWQ Central Flies Total Event reclpttatlon (Inches); / 1617 Mali Sorvloe Center Raleigh, North Carolina - 27699-1617 Date (list each ndditioual event sampled this reporting pe0od, and rainfall amount) Total Event Precipitation (inches); FEB 18 2G19 AIL i-kC-1 SECTIOPL S WU-249-102107 Page I of 2 9 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, tare, accurate, and complete, X am awareAlint there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations," Z �fl (Signature of Permittee) (Date) 5 WU-249-102101 Page 2 or Environmental Chemists, Inc. 6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax 710 Boivsertown Road, Man teo, NC 27954 . 252.473.5702 Lab/Fax 255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax info@environmen(alchemists.com House of Raeford Date of Report: Jan 11, 2019 Post Office Box 40 Customer PO #: Rose Hill NC 28458 Customer ID: 08100079 Attention: Joe Teachey Report #: 2018-21275 Project ID: Stormwater Lab ID Sample ID: Collect Date/Time Matrix Sampled by 18-53558 Site: NTS1 12/21/2018 1:15 PM Water Client Test Method Results Date Analyzed Oil & Grease (O&G) EPA 1664 <5 mg/L 01/07/2019 Residue Suspended (TSS) SM 2540 D 14.7 mg/L 12/24/2018 pH SM 4500 H B 7.71 units 12/26/2018 COD SM 5220D 36 mg/L 01/03/2019 Lab ID Sample ID: Collect Date/Time Matrix Sampled by 18-53559 Site: OTS1 12/21/2018 1:23 PM Water Client Test Method Results Date Analyzed Oil & Grease (O&G) EPA 1664 <5 mg/L 01/08/2019 Residue Suspended (TSS) SM 2540 D 9.0 mg/L 12/24/2018 pH SM4500 H B 7.46 units 12/26/2018 COD $M 52200 31 mg/L 01/03/2019 Lab ID Sample ID: Collect Datefrime Matrix Sampled by 18-53560 Site: OTS2 12/21/2018 1:27 PM Water CUent Test Method Results Date Analyzed Oil & Grease (O&G) EPA 1664 <5 mg/L 01/02/2019 Residue Suspended (TSS) SM 2640 D 7.9 mg/L 12/24/2018 pH SM 4500 H B 7.21 units 12/26/2018 Cob SM 5220D 43 mg/L 01 /0312019 Comment: Reviewed by: WiLL_ Am Report #:: 2018.21275 ENVIRONMENTAL CHEMISTS, INC NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 3T729 6602 Windmill Way Wilmington, NC 28405 OFFICE: 910-392-0223 FAX 910-392A424 into@environmentalchemists.com Client: House of Raeford PROJECT NAME: Stormwater REPORT NO: ADDRESS: CONTACT NAME: PO NO: REPORT TO. PHONEJFAX: COPY TO. -Chris Murray email: Sampled By: SAMPLE TYPE: I = Influent E = Effluent W = Well ST = Stream SO = Soil SL = Sludge, Other: ANALYSIS REQUESTED i� 11��M=111111 IeRecel oil Temperature Delivered By: Co STORMWATER DISCHARGE OUTFALL (SDO) MONTTO RING REPORT GENERAL PERMIT NO. NCG060000 SAMPLES COLLECTED DURING CALENDAR YEAR: CERTIFICATE OF COVERAGE NO, NCG (This monitoring report is due at the Division no later than 30 days from the date the facility receives the sa plio reslulfrom the laboratory.) FACILITY NAME 1y ' 1 Af LABORATORY COUNTY PERSONALES ONNO.i� CERIFIED Lab RECEIV bZ Lab # JUN 2 5 2018PLEASE SIGN ON THE REVERSE Part A: Specific Monitoring Requirements CENTRAL FILES �,.,q r. pe -rinks Outfall No. Date Sample Collected, mo/dd/ r . 00530 00400 ' ""00340 00556 31616 Total Suspended Solids, m pH, Standard units Chemical Oxygen Demand, m Oil and Grease, mg/L Fecal Coliform, Colonies per 100 ml Benchmark 100 Within 6.0 — 9.0 120 30 1000 r - / r_ t: ✓, Note: if you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier i or "Fier 2 responses. See General Permit text. Did 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 oultoring Reg uirements Outfall No, Date Sample Collected, mo/dd/ r 00556 00530 00400 OR and Grease, m Total Suspended Solids, m pH, Standard units New Motor Oil Usage, Annual averse al/mo Benchmark 30 100 6.0 — 9.0 - P 2 1 o ' 1 S1 r ., e Note: If you reporfa sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I or Tier 2 responses, See General Permit text. STORM EVENT CHARACTERISTICS: Data (first event sampled) Total WvehPrecipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches). - Mail Original and one copy to: Division of Water Quality Attu: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 S W U-2d9-102107 Page I of 2 III 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." (Signature of Permittee) (Date) S W U-249-102107 Page 2 of 2 Environmental Chemists, Inc. 1 1 6602 Windmill Way, Wilmington, NC 28405 . 910.392.0223 Lab . 910.392.4424 Fax 710 Bowsertown Road, Manteo, NC 27954 . 252.473.5702 Lab/Fax srn 255-A Wilmington Highway, Jacksonville, NC 28540 . 910.347.5843 Lab/Fax ANALYTICAL & CONSULTING CHEMISTS info@environmentalchemists_com House of Raeford Date of Report: May 07, 2018 Post Office Box 40 Customer PO #: Rose Hill NC 28458 Customer ID: 08100079 Attention: 'Chris Murray Report#: 2018-06461 Project ID: Stormwater Lab ID Sample ID: Collect DatefTime Matrix Sampled by 18-16092 Site: OTS1 4/24/2018 4:43 PM Water Chris Murray Test Method Results Date Analyzed Oil & Grease (O&G) EPA 1564 <5 mg/L 04/27/2018 Residue Suspended (TSS) SM 2540 D 4.9 mg/L 04/26/2018 pH SM 4500 H B 6.93 units 05/01/2018 COD SM 5220D 43 mglL 04/27/2018 Lab ID Sample ID: Collect DatelTime Matrix Sampled by 18-16093 Site: OTS2 4/24/2018 4:55 PM Water Chris Murray Test �— Method Results Date Analyzed Oil & Grease (O&G) EPA 1664 <5 mg/L 04/27/2018 Residue Suspended (TSS) SM 2540 D 9.6 mg/L 04/26/2018 pH SM 4500 H e 6.89 units 05/01/2018 COD SM 5220D 48 mg/L 04/27/2018 Environmental Chemists, Inc. 6602 Windmill Way, Wilmington, NC 28405 . 910.392.0223 Lab . 910.392.4424 Fax 710 Bowsertown Road, Manteo, NC 27954 . 252,473.5702 Lab/Fax 255-A Wilmington Highway, Jacksonville, NC 28540 . 910347.5843 Lab/Fax info@environmentalchemists.com House of Raeford Date of Report: May 07, 2018 Post Office Box 40 Customer PO #: Rose Hill NC 28458 Customer ID: 08100079 Attention: Chris Murray Report #: 2018-06461 Project ID: Stormwater Lab ID Sample ID: Collect DatelTime Matrix Sampled by 18-16089 Site: GE1 4/24/2018 11:15 AM Water Chris Murray Test Method Results Date Analyzed Oil & Grease (O&G) EPA 1664 <5 mg/L 05/0212018 Residue Suspended (TSS) SM 2540 D 8.1 mg/L 04/26/2018 pH sM4500 H B 6.65 units 05/01/2018 COD SM 5220D - 50 mg/L 04/27/2018 Lab ID Sample ID: Collect Daterrime Matrix Sampled by 18-16090 Site: GE2 4/24/2018 11:23 AM Water Chris Murray Test Method Results Date Analyzed Oil & Grease (O&G) EPA 1664 <5 mg/L 04/27/2018 Residue Suspended (TSS) SM 2540 D 20.4 mg/L 04/26/2018 pH SM4500 H B 6.32 units 05/01/2018 COD SM 5220D 48 mg/L 04/27/2018 Lab ID Sample ID: Collect Daterrime Matrix Sampled by 18-16091 Site: New Track Shop SW1 4/24/2018 4:20 PM Water Chris Murray Test Method Results Date Analyzed Oil & Grease (O&G) EPA 1664 <5 mg/L 05/02/2018 Residue Suspended (TSS) SM 2540 D 27.7 mg/L 04/26/2018 pH SM 4500 H B 6.62 units 05/01/2018 COD SM 5220D 27 mg/L 04127/2018 E--MAILED MAY 0 7 2015 Report#.-: 2018-0Wl Pagel of •'�iJ STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT GENERAL PERMIT NO, NCO060000 CERTEnCATE OF COVERAGE NO, NCG0219,V7 FACILITY NAME A01 ;Zj�j PERSON COLLECTING SAA1PL J CERTIFIED LAbORATORYrvj&/' ' Lab # Q1 Lab # Part A: Speciflc Monitoring Requirements SEp 2 2 N �RL�Ct:,e�r�ltr � 1Y, SAMPLES COLLECTED DURING CALENDAR YEAR; (This monitoring report is due at the Division no later than 30 days from the date the facilityreceives the s It is rom the laboratory.) PHONE NO, n C— PLEASE SIGN ON THE REVERSE -3 Outfall I Date 00530 1 00400 - 00340 _ 00556 No, Sample Total Suspended pH, Chemical Oxygen Oil and Or Collected, Solids, Standard units Demand, mg/L < < 1 77R'r ote: you report a sampled value in excess See General Permit text. 100 Within 6.0 -- 9,0 12 )f the benchmark vaIu tf, or outside the 30 31616 Focal Coliform, Colonies per 100 ml 11 range for pH, you must implement Tier I or Tier•2 responses, Did 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 Outfou No, Date Sample Collected, mo/dd/ r 00556 00530 00400 Oi_I and Grease, m Total Suspended SoUds, m PH, Standard units New Motor Oil Usage, Annual ayes a ol/mo Benchmark 30 100 6,0 — 9,0 - 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. STORM EVENT CHARACTERISTICS; Date —9 J first event sampled) Total Event Precipitation (inches); - 7 Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches); Mail Original and one copy to; Division of Water Qual Ity Attn: DWQ Central Files 1617 Mail Service Canter Raleigh, North Carolina 27699-1617 S WU-249-102107 Pagel of2 I "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," (Signature of Permittee) � 1/2, -- �/,/ � 2 ate) y SWU-249-i02107 Page 2 of 2 4.' 4 -Environmental-Chemists,-Inca —;-..._._- " ® A 6002 Windmill IMly, Wilmington, NC 28405 ' 910.392.0223 Lab ' 910.392.4424 Fax 710 Bmvsertotvn [toad, lvtantetl, NC 27954 • 251473.5702 Lab/Fax 255-A Wilsningttmt Highway, JacksonvilIt,, NC 28540 " 910.347.5843 Lab/Fax ANALYTICAL & CONSULTING CHEMISTS info a.eilvironlnenlsichemists.corn House of Raeford Date of Report: Sep 15, 2017 Post Office Box 40 Customer PO #: Rose Hill NC 28458 Customer ID: 08100079 Attention: Chris Murray Report #: 2017-12960 Project ID: Stormwater Lab ID Sample ID: Collect Date[Time Matrix Sampled by 17-31081 Site: Outfall TS1 8/29/2017 10:04 AM Water Client Test Method Results Date Analyzed Oil & Grease (O&G) EPA 1664 <5 mg/L 09/08/2017 Residue Suspended (TSS) SM 2540 D <4.2 mg/L 08/30/2017 pH SM 4500 H B 7.17 units 09/07/2017 COD SM 5220D 68 mg/L 08/31/2017 Lab ID Sample ID: Collect Date[Time Matrix Sampled by 17-31086 Site: Outfall TS2 8/29/2017 10:12 AM Water Client Test Method Results Date Analyzed Oil & Grease (O&G) EPA 1664 <5 mg/L 09/08/2017 Residue Suspended (TSS) SM 2540 D 26.3 mg/L 0813012017 pH SM 4500 H B 7.26 units 09/07/2017 COD SM 5220D 85 mg/L 08/31/2017 Lab ID Sample ID: Collect DatelTime Matrix Sampled by 17-31087 Site: Outfatl TS3 8/29/2017 10:27 AM Water Client Test Method Results Date Analyzed Oil & Grease (O&G) EPA 1664 <5 mg/L .09/08/2017 Residue Suspended (TSS) SM 2540 D 7.0 mg/L 08/30/2017 pH SM 4500 H B 7.48 units 09/07/2017 COD SM 5220❑ 20 mg/L 08/31/2017 Comment: Reviewed by: Reporl #:: 2017-12960 Pam 1 of 1 i Analytical & Consulting Chemists ENVIRONMENTAL CHEMISTS, INC NCDENR: DWO CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 COLLECTION AND CHAIN OF CUSTODY 6602 Windmill Way Wilmington, NC 28405 OFFICE: 910-392-0223 FAX 910-392-4424 info@environmentalchomists.com Client: House of Raeford PROJECT NAME: Stormwater REPORT NO: ' I q h ADDRESS: CONTACT NAME: PO NO: s '€ REPORT TO: PHONE/FAX: COPY TO:Chris Murray email: Sampled By: SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other: Sample Identification ANALYSIS REQUESTED Co ,MU.1.[M�MM�=MMIllllllCOD,TSS,O&G,pH M MIAMI Temperature he ecel di: �� Acceet3: Rejected: Delivered By: � �iLi (/ Received By: TURNAROUND: 4 GEi4ERAL PERMIT NO, NCG060000 CERTIFICATE OF COVERAGE NO, NCG FACILITY NAM. ljf/eW PERSON COLLECTING SAMPLES CERTIFIED LABORATORY ZA—)j Part A: Specific Monitoring Requirements STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Lab#� Lab 4 SAMPLES COLLECTED DURING CALENDAR YEAR; (This monitoring report Is due at the Division no later than 30 days from thold,at�CEI� the facility receives the sa pI] results om the laboratory,) �NO,i jf� � FEB 0 t 7 PEASE SIGN ON THE REVERSE 4 CENTRAL FILES DWR SECTION Outfall No. Date Sample Collected, moldd/ r 00530 00400 00340 00556 31616 Total Suspended Solids, m pH, Standard units Chemical Oxygen Demand, m Oil and Grease, mg/L Fecal Coliform, Colonles per 100 ml Hencbmark - 100 Within 6.0 — 9,0 120 30 1000 & 4117 3 S-7 �, J -7 Note: if you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I or Tier-2 responses, See General Permit text, Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ es _no (If yes, complete Part B) Part S; Vehicle Maintenance Activity Monitoring Requirements Outfou Na, Date Sample Collected, molddl r 00555 00530 00400 Oil and Grease, m Total Suspended Solids, mgtL pH, Standard units New Motor Oil Usage, Annual averse gothno Benchmark 30 100 6,0-9.0 - r r'y 10/ Nble: Iryou report a sampled value in excess of the benchmark value, or outside the benchmark range for pil, you must Implement Tier I or Tier 2 responses, See General Permit text. STORM EVENT CHARACTERISTICS: Date 1� (first event sampled) s( Total Event Precipitation (inches), _ _ s voFC7 Date (list each additional event sampled this reporting pariod, and rainfall amount) Mall Original and one copy to, Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carollna 27699.1617 j �pz Total Event precipitation (inebes): S WU-249-102107 Page I of 2 9 certify, under penalty of law, that this document and all attachmeuts were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the informnatiouNubmitted. Based an my In""quiry 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. X am aware.that there are significant penalties for submitting false information, including the possib'lity of fines and imprisonment for knowing violations," (Signature of Permittee) • `� (Date) V - .ti 1 A S WU-249.102107 Page 2 or Environmental Chemists, Inc. r e 0 r 6602 Windmill Way, Wilmington, INC 28405 • 910.392.0223 Late 910.392.4424 Fax 710 Bowsertown Read, Manteo, NC 27954 • 252,473,5702 Lab/Fax t 255-A Wilmington Highway Jacksonville, NC 28540 • 910,347.5843 Lab/Fax ANALYTICAL 8 CONSULTING CHEMISTS into a environnlentalcliemists.conl i House ofRaeford D ate -of- Re part: — Feb-07,-201-7—-------- Post Office Box 40 Customer PO #: Rose Hill NC 28458 Customer ID: 08100079 Attention: Chris Murray Report #: 2017-01063 Project ID: Nash Johnson Stormwater Lab ID Sample ID: Collect Date/Time Matrix Sampled by 17-02555 Site: Outfall 01 1/23/2017 11:10 AM Water Client Test - Method Results Date Analyzed Oil & Grease (0&G) EPA 1664 <5 mg/L 02/06/2017 Residue Suspended (TSS) SM 2540 D 20.2 mg/L 01/24/2017 pH SM 4500 H a 7.03 units 02/01 /2017 COD SM 5220D 57 mg/L 01/26/2017 Lab ID Sample ID: Collect DatelTime Matrix Sampled by 17-02556 Site: Outfaff 02 1/23/2017 11:20 AM Water Chris Murray Test Method Results Date Analyzed Oil & Grease (O&G) EPA t664 7 mg/L 02/06/2017 Residue Suspended (TSS) SM 2540 D 22.2 mg/L 01 /24/2017 pH SM 4500 H B 7.28 units 02/01/2017 COD SM 52200 57 mg/L 01 /26/2017 Lab ID Sample ID: Collect DatelTime Matrix Sampled by 17-02557 Site: Outfall 03 1/23/2017 11:36 AM Water Chris Murray Test Method Results Date Analyzed Oil & Grease (O&G) EPA 1664 <5 mg/L 02/06/2017 Residue Suspended (TSS) SM 2540 D 4.0 mg/L 01/24/2017 pH SM 4500 H B 7.95 units 02/01 /2017 COD SM5220D 20 mg/L 01/26/2017 Comment: Reviewed by. ' �t ReportC 2017-o1083 ENVIRONMENTAL CHEMISTS, INC NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 COLLECTION AND CHAIN OF CUSTODY 6602 Windmill Way Wilmington, NC 28405 OFFICE: 910-392-0223 FAX 910.392-4424 info@environmentalchemists.com Client: House of Raeford ) PROJECT NAME: Stormwater REPORT NO: Z ADDRESS: . .J S S CONTACT NAME: PO NO: REPORT TO: PHONE/FAX: COPY TO:Chris Murrayemail: Sampled By: i SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other: - Sample Identification Collection m m E 5 m a r o 2 G cCS o tj d t a U 9 w m n z PRESERVATION ANALYSIS REQUESTED Date Time Temp z i = $ s o = 0 z 0 ~ = p Outfall: "A9 C P X. X COD,TSS,O&G,pH G G Outfall: l ' -;zo C P 1� COD,TSS,O&G,pH G G Outfall: C P loz�p X �' ICOD'TSS,O&G,pH G G Outfall: C P X X G G Outfall: C P G G C P G G C P G G E C P G G j C P G G i Transfer ! Relinquished By: DatelTime Received By: DatelTime ,. � � .z3 l•. �' rrr 1 2. i Temperature when Received: 1 6epted: / ejected: Resample Requested: Delivered By: Received By:„ Date: Time: Comments: f� TURNAR UND: sec-oW_0�y7 TER DISCHARGE ]%1 c 610F06 �TORMW MONTTORTNG REPORTALL (SDO) I j 7 GENERAL PERMIT NO, NCG060000 %� CERTIFICATE OR COVERAGE NO. NCG FACILITY NAME /t✓i�1,1L'a�cS PERSON COLLECTING SAMPLES /1 y CERTIFIED LABORATORY x .cXl 1#651 i5��-�J'J Lab #1 29 Lab # Part A: Specific Monitoring Requirements �� ECTED DURING CALENDAR YEAR; o 15i's mo'nit�orlbg report is due at the Division no later than 30 days from gghpIqlIlty receives the sampling rests from the laboratory.) COUNTY CENTRAL FILES PHONE NO. — Z DWR SECTION PLEASE SIGN ON THE REVERSE 4 RECEIVED Outfall No, Date Sample Collected, mo/dd/ r 00530 00400 00340 00556 31616 M Total Suspended Solids, m pH, Standard units Chemical Oxygen Demand, m Oil and Grease, mg/L Fecal Collform, Colonies per 100 t Benchmark - 100 Within 6.0 — 9.0 120 30 1000 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 Tier2 responses, See General Permit text, Did 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 Outfail No, Date Sample Collected, mo/dd/ r 00556 00530 00400 OR and Grease, m Total Suspended Solids, m pH, Standard units New Motor Oil Usage, Annual average al/mo Benchmark 30 100 6.0 -- 9.0 S / 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. STORM EVENT CHARACTERISTICS: Date (first event sampled) Total vent Precipitation (inches): .5 Date (list each additional event sampled this reporting peflod, and rainfall amount) Total Event Precipitation (Inches): Mail Original and one copy to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 AP n 7 ITRAL FILE: R SI;CTIO�� SWU-249-102107 Page 1 of 2 "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." l (Signature of Permittee) (Date) S WU-249-102107 Page 2 of 2