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HomeMy WebLinkAboutNCS000037_MONITORING INFO_20190701STORMWATER DIVISION CODING SHEET NCS PERMITS N �S O� O v `� PERMIT NO. DOC TYPE [I FINAL PERMIT MONITORING REPORTS ❑ APPLICATION ❑ COMPLIANCE ❑ OTHER -)Uj� DOC DATE ❑ YYYYMMDD STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Permit Number NCS bon 3 SAMPLES COLLECTED DURING CALENDAR YEAR: a O (-I (This monitoring report shall be received by the Division no later than 30 days from /� the date the facility receives the sampling results from the laboratory.) FACILITY NAME C. a r m 0Gs fi I' ICt 11COUNTY e c, k l e.. PERSON COLLECTING SAMPLE S) CTIONE NO. 70 CERTIFIED LABORATORY(S) JJA CLr' ^_Lab # t-10 tl. C 4 a ri ft , Lab # 560 (SIGNATURE OF PERMITTEE OR DESIGNEE) Part A: Specific Monitoring Requirements By this signature, I certify that this report is accurate complete to the best of my knowledge. :Outfall Date 150050'- ' `Y�Q` Q, v0• :� O No: Sample :: " Total Total -� :Collected... Flow.(if a }:` ,Rainfall �` =tnoldd/''r 3MG. inc€ies M �.-.{� per. t7r— A, f,, -n- 1 i. J.4 '15i 14 .� LF Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per mbnth? _ yes _no (if yes, complete Part B) Part R- VohirTn Mnintonnnro Activity Mnnitnrina RPniiiVampntc Outfall Date0050; Sample-. ;Collected f j ` ,x :00556 00530 0040Q,.,, :Total'F7ow (if applicable}„ TotaG Ra�nill. Oil& -Grease [ifappl.) ' Non polar :O&G/TPH� ' = (IVlethod1664" SGT IEM)s:if ap6l. Total: 5uspextded S6lids_rx pH° New-1Vlotor O►1 Usage mo/dd/ _r"; MG' 'inches::. m - unit . ^ aUmo Form S W U-247-062310 Page 1 of 2 STORM EVENT CHARACTERISTICS: Date 1'1?-11 Total Event Precipitation (inches): Event Duration (hours): (only if applicable — see permit.) (if more than one storm event was sampled) Date Total Event Precipitation (inches): Event Duration (hours): (only if applicable — see permit.) Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 "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 person$ who manage the system, or those persons directly responsible for gathering the informatiop,' the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that them are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of ermittee) (Date) Form S W U-247-062310 Page 2 of 2