NCG140018_MONITORING INFO_20021204

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ u w o d,-/
YYYYMMDD

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�"TotalEvent'Pieci itation! inches :•++
K.,..,ki_�aEvent=Diiiationt hours 't�t��c�`
StormwaterDischarge Monitoring
qa�
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+ inches
� Yc�Sust"SYIP
hours
Std.aUmts `:
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NA DISCHARGE OUTFALL MONITORING REPORTCEIVEID
NCDENR GENERAL PERMIT NCG140000
DEC - 4 2002
(All sample data shall be reported no later than 30 days after receipt of lab results) DWQ_W (i RO
Certificate ofCoveragq
NCG14 OQQOI
Facility Name.,, 1
_57
Jl� o
County,t µ ``i
I.�A
Nre
Phone Numbei �
'
Certified Laboratory #
a✓n
CI�Y�,-�
min q
S�S J-tJC
Per C' 61 llecting Satnple(s)'.
A�
G4
Collectors Stgnatuie
_..__.._. Sample Information.`...._
Perntrt Term`
i Year S6iUEfid!Diites ">
Place check markito mdtcate
Discharge Type (check as apliropnate)'
APOa�h ablesain hit 'od
r+. e
Storiitwater,trf Wastewater,.+,
_
Au -usf 1, 1999 toJuly 31, 2000
❑
l
ID ` 'L
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❑
❑
❑
u. ❑
❑
r
❑
❑.^, ',.
2 " '
', August 1, 2000 to July 31, 2001
3 +
August 1, 2001 tojuly 31, 2002
4 ,, :,
s. Au ust 1, 2002 to July 31, 2003
715 i:.b!!:Au
ust.1;2003to'Jul 31 2004
r -
1� 1•: 1 1
Part A Stormwater Discharge Moriitoi mg Data (For stormwater not combtned.Nvith process wastewater) '
_.., Storm`'Event Cliaracteristics
w
Does this facility perform Vehicle Maintenance Activities using on average more than 55 gallons of new motor
oil per month? ❑ Yes ❑ No If yes, complete information below.
Stormwater Discharge Monitoring from Vehicle Maintenance Areas
Outfallyfi
r Not 5.
°- '.•_:
;D'ateSample
Collected c f
, (mo/dd/ r)$
Total,Flow
?{;(IvIG)r, k?
Tortal�Eventt
Preciptiation
��. finches)
Event'A
Durahon�,
K (hours
^Naw wa
Motor Otl..:
cUsage4 ,
.,.( aVruo
t w pHt:`
3 rt d"., "�
t
(Std.'Units ,
dotal {t
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SWU-241-080199 Page lof 2

Part B: Process wastewater discharge monitoring data
Sample #
Effluent Source(s) for this sample ✓
Vehicle / Equipment Cleaning E j
Raw Material Stock -pile Wettingtrf
Mixing Drum Clean -out IJ
Recycle System Overflow
Paza'metei
Collection Date -
mo/dd/yr
Total Flow
MG
o9B
Event Duration
hours
8m
pH
Std..units
11.E
Settleable Solids
. _' mUl
'Sample #,- ' 7/ -
?a`s`Efflueni�Souice(s)rfor thts�saiii le„
Vehicle ( Equipment Cleanin
❑
.,Raw Material Stock= ile Wettm
'Mikin''Drum Clean` --out
Recycle System Overflow
TParune�ec�
I ;Umi
� NlW7;}c:
Collection Date
mo/dd/yr
Total Flow
MG
b93
Event Duration
hours
ti -
p13
Std. units
1 3
TSS
mg/I
Settleable Solids.
ml/I
—
Mail original and one copy to:
Attn: Central Files
Division of Water Quality
DENR
1617 Mail Service Center
Raleigh, NC 27699-1617
Sample #
Effluent Source(s) for this sample
✓
Vehicle / Equipment Cleaning
❑
Raw Material Stock -pile Wetting
❑
Mixing Drum Clean -out
❑
Recycle System Overflow
❑
Parameter r t
- Unit :
Data
Collection Date
mo/dd/yr ,
Total Flow ,
MG
Event Duration
hours
pH
Std. units
TSS;
mg/1
,
Settleable Solids
mUl
Sample #.
.EffluentlSource(s)>for ftii's''s`a le�'�i
: ?.
Vehicle r ui merit Cleanin
❑
.Raw MaCenal.Stock ile Wettin
❑
Mixing �'DrumClEan'out '^tai`
❑"
•Rec' cWS stem Overflow
❑
9Paraiiieter
;sUmt*
Data
Collection Date
mo/dd/yr
Total Flow
MG
Event Duration
hours
OH
Std: units
TSS
mg/l
Settleable Solids
ml/1
"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."
(Print Name of Permittee or Designee)
, ,..� HArI� C—Gn-, 111i I o-V
tgnature of Permittee or Designee) T (Date)
MIUDZ aItotnia
Page 2 of 2