NCS000373_COMPLETE FILE - HISTORICAL_20190905

- --STORMWATER DIVISION CODING -SHEET,..-.
RESCISSIONS.
PERMIT NO.
N�500
DOC TYPE
COMPLETE FILE- HIS70RICAL
DATE OF
RESCISSION
p ��%� M 0S
YYYYMMDD

STOWNINVATER DISCHARGE 0UTFALL (SDO)
MONITORING REPORT
Permit Number NCS 000373 SAMPLES COLLECTED DURING CALENDAR YEAR: 2019
(This monitoring report shall be received by the Divisiun no later than 30 days from
the date the facility receives the sampling results frorn the laboratory.)
FACILITY NAME _Michelin Aircraft Tire Company_ ^ _
PERSON COLLECTING SANIPLE(S) Chris Crisler, HeatherAshb
CERTIFIED LABORATORY(S) Pace Analytical L a b # PP,S C, # ld
Pace Analytical Lab # PASI-C
�Lr 06 2019
Part A. Specific Monitoring Requirements
CEt4TRAL FILES
DM SECTION
COUNT)' Stanly
PEIONE NO. (704 ) 474-7777
SIGNATURE OF PERM IYFEE OR DESIGNEE
REQUIRED ON PAGE 2.
.Outfall
Date
50050
0i ! tea
No:
Sample
Collected
Total -
Flow if app.)
Total
Rainfall
mo/ddl r
MG
inches
L
5 r urr,
SDO1
7/23/19
NIA
.36
ND
6.30
$.1
SDO 2
7/23/19
N/A
.36
ND
7.09
131
Awl
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ()yes eno
(if yes, complete Part B)
cart ts: venicre Maintenance Activity Monitoring
Ke urrements
Outfall
Date ' :
50050
00556.
00530
00400 .
To afflow
Total'
Oil Grease -;
Non -polar
Total
pH .;
New t)7otor
No
Sample
Collected.
(if applrc.ible)
Rainfall '
(if appl:)
O&G/TPH:.
Suspended
Oil Usage
(Method 1664
Solids,
..
SGT-14EV1); if
appl.
.
:mo/dd/vr
911E
inches
I=MIYI
mgll
unit
galInto
Form S W U-247• last revised 6112/201
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date 7/23/201
Total Event Precipitation (inches): .36
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 Energy Mineral and Land Resources
Attn: Central Files
1617 IMaiI Service Center
Raleigh, North Carolina 27699-1617
"I certify, under penalty of [aw, that this document and aI] 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 thelpossibility of fines and imprisonment for knowing violations."
4--" 1912011
Signature of Per mitt (Date)
Form SWU-247, /usl revised 611212015
Page 2 of 2