NCS000336_MONITORING INFO_20200114

STORMWATER DIVISION CODING SHEET
NCS PERMITS
PERMIT NO.
DOC TYPE
❑FINAL PERMIT
MONITORING REPORTS
❑ APPLICATION
❑ COMPLIANCE
❑ OTHER
DOC DATE
❑ d� V U
YYYYMMDD

R E CM�NITORING REDIs GRE, OTRgALLT (s")
POR
PsrmhN®berNCS 000336 JAN 14 2020
CENTRAL FILES
FACILITY NAME UFP Elizabeth City DWR SECTION _
PERSON COLLE(.MG �- -.
CERTWIXD LABORATORY Lab #
Lab #
Part A: Spm& Monitoring Requmments
5AmPLEs OOLLEcrm DURII+IG CALENDAR YEAR: 2019
(This om oring report siali be reoeivrd by the Dhidm *o later than 30 days from
the date the fi m'hty revel m the sampi erg results fora the laboratory.)
COUNTy Pasquotank
PHONE NO. [phone]
E
TUREOF PTRhf TPEE OR DESIGNRE
TIRED ON PAGE 2.
1 •
Does dais faraihy perform Vehicle Mambmmw Activities msmg mom than 59 galk ms of new m - r oa7 per n>awffi? —yes X na
CtfYm ompieft PutD)
Part H: Vesicle hfmhd am Aebwdv Mmko rhm Rm>tf vmmasrta
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Fora SWU-247, 1m7 ► rMed 2aaO12
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STORM EVENT CHARACI'ERLSTIC5: Mad Original amil one Copy to:
Division of Water Qwhty
Drtr NA Attu Central files
Total $Pant Prse4itrtion (lnebq): NA 1617 Mail Service Center
Event Duration (boars): NA (only ifappiicnble —see prrrait.) Raleigh North Cwobm27699.1617
(if nacre than cm storm event was sampled)
Date]_
Total Event Ang
Event Damon (iMnr ' ` NA (only ifsipphcable -aft pamit.)
"I cm t 4, trader penalty of law, that tbis docu n ut and all attsAmsats were prepared aver my directloa or supervision in aceordalaee wilt a
system mad to assure that gaaUfled puwnad properly gatber and cnduate the Eafotmation submitted. Based on my iagairy or the person
or persons who manage the syst=4 or those persons directly responsible fur gathering the information, the hdormatim sabmttted it, to the belt
of ary lmowkdge and bcH4 accarate zed complete. lam aware tbad there are dgaifiewd penalties for sabmitthq false information,
iacbudimg the_JpwICffjqbf and iaprboument for knowing viclattoas."
Form SWU 247, last revised 21212012
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