NCS000202_COMPLETE FILE - HISTORICAL_20191106

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-STORMWATER DIVISION CODING SHEET
RESCISSIONS.
PERMIT N0.
l N l., S 0 I) D C�A
DOC TYPE
COMPLETE FILE- HISTORICAL
DATE OF
RESCISSION
p. u I� I I D
YYYYMMDD

STORMIWATER DISCHARGE OUTFALL (SDO)
i%IONITORING REPORT
Permit Number: NCS 000202 or
Certificate of Coverage lumber: NCG
FACILITY NAME United States Gypsum Co.
PERSON COLLECTING SAI7PLE(S) o.v'ts nnc
CERTIFIED LABORATORY(S) a
Lab #
Part A: Specific Monitoring Requirements
SAIIPLES COLLECTED DURING CALENDAR YEAR: 2Zk 1 0 CTO 6 C
(This monitoring report shall he received by the Division no later than 30 days from
the date the facility receives t} a sampling results from the laboratury.)
Mitchell
( 828 ) 765 - 9481
(SICNr sThe
E OF PERIIITTEE OR DESIGNEE)
By this ture, I certify that this report is accurate
complete best of my knowledge.
Outfall
Date
1.
Sample
Collected
1 Total1
1
1
1' 1 1
Solids
r 1
1
Does this facility perform Vehicle Maintenance Activiiies using more than 55 gallons of new molar oil per month) _ yes V nO
(if -yes, Complete Part B)
Part H: Vehirle lraintenance Activity NInnitorins- Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
fif applicable)
Total Rainfall
Oil & Grease
Total
Suspended
Solids
pH
New Motor Oil
Usage
mo/ddtvr
MG
inches
m
m
Units
gavmo
RECEIVE
NOV 0 6 2019
CENTRAL FILES
DWR SECTION
Form S W U-246-112608
Page 1 of 2

STOWU EVEp
VENT CHARACTERISTICS:
Date to p A 1 11
Total Event Precipitation (inches):
F,vent 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 persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best
of tm knowledge anO+elief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
iyr"Jing4k pussi iii y of fines and imprisonment for knowing violations."
(Signature
r1 `,Y 1
(Date)
Form SWU-246-112608
Page 2 of 2