NCG160193_MONITORING INFO_20140408

STORMWATER DIVISION CODING SHEET
NCG PERMITS
-------------------
PERMIT NO.
/v L& ) ( oI q 3
DOC TYPE
❑ HISTORICAL FILE
5d MONITORING REPORTS
DOC DATE
❑ o? O ) Ll'a
YYYYMMDD

STORMWATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG160000
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE OF COVERAGE NO. NCG16 1 1❑R© SAMPLES COLLECTED DURING CALENDAR YEAR:
(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.)
FACILITYNAME &1-17*50" Qt-Af'l COUNTY NASH
PERSON COLLECTING SAMPLES 5ra-rlr USa-FG PHONE NO. (2 i l ]o4-S149
CERTIFIED LABORATORY6-+1jtRasmewr I t 1 Nc- Lab # 1
Lab #
Monitoring Requirements
Outfall
No.
Date
Sample Collected,
mo/dd/ r
Total Rainfall,
inches
00530
00400
00556
Total Suspended Solids, mg/I
pH,
Standard units
Total Petroleum Hydrocarbons, mg/l
EPA Method 1664 (SGT-HEM)
Benchmark
100
Within 6.0 - 9.0
15
dr-
If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier I 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."
/ J Yn��}�11
(Signal a of Permit te
(Dale)
SWU-252-051409
Page 1 of I

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GREEWLLE, N.C. 27835-7085
ROSE BROTHERS (BATTLEBORO)
W. REID CLARKE
P.O. BOX 806
AHOSKIE ,NC 27910
PARAMETERS
PH (not to be used for reporting)
Total Suspended Residue, mg/I
TPH (1664A), mg/I
Stormwater Analvsis Method
(#1, Grab) Date Analyst Code
7.5 04/09/14 TRB 4500HII-00
11 04/10/14 CMC 254OD-97
<5.0 04/16/14 SEd EPA166413
ID#: 494
DATE COLLECTED: 04/08/14
DATE REPORTED : 04/16/14
REVIEWED BY: