NCG160099_MONITORING INFO_20140505

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PEWIT NO.
DOC TYPE
❑HISTORICAL FILE
L�MONITORING REPORTS
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YYYYMMDD

RECEIVED
STORMWATER DISCHARGE OUTFALL (SDO) MAY O 5 Z0 4
GENERAL PERMIT NO. NCG160000
DISCHARGE MONITORING REPORT (DMR) CENTRAL FILES
CERTIFICATE OF COVERAGE NO. NCG1691Q®®
FACILITY NAME Mu���P�a �af - I
PERSON COLLECTING SAMPLES 5c-al-t t+-sb L—f=E-
CERTIFIED LABORATORY Wu 'a--i "tom P Lab # D
Lab #
Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEO
AR U`G I -�`
(This monitoring report is due at the Division no later than 30 days from the date
the facility receives the sampling results from the laboratory.)
COUNTY (4 E211Poa-D
PHONE NO. (4a!=) ZP4 —$ t 44
Outfail
No.
Date
Sample Collected,
mo/dd/ r
Total Rainfall,
inches
00530
00400
00556
Total Suspended Solids, mg/l
pH,
Standard units
Total Petroleum Hydrocarbons, mg/I
EPA Method 1664 SGT-HEM)
Benchmark
-
-
100
Within 6.0 — 9.0
15
If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit.
Mail original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"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."
!q zl 1
(Date)
SWU-252-051409
Page 1 of 1

P.O. 7D BOX 85, 114 OAkWNT DRIVE
GREENVILLE, N.C. 27835-7065
ROSE BROTHERS (MURFREESBORO)
W. REID CLARKE
P.O. BOX 806
AHOSKIE ,NC 27910
PARAMETERS
PH (not to be used for reporting)
Total Suspended Residue, mg/1
TPH (1664A), mg/1
Stormwater Analysis Method
(#I, Grab) Date Analyst Code
7.9 04/09/14 TRB 4500HB-00
460 04/10/I4 CMC 2540D-97
<5.0 04/11/14 SE.1 EPA1664B
PHONE [phone]--
FAX [phone]
ID#: 489
DATE COLLECTED: 04/08/14
DATE REPORTED : 04/11/14
REVIEWED BY: