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K.'r-'a
Environmental
Quality
Stormwater Discharge Outfall (SDQ)
Qualitative Monitoring Report
For guidance on filling out this form, please visit https:Hdeq.nc.gov/about/divisions/energy-mineral-land-resourcesi
npdes-stormwater-gps
Permit No.: N/C/ / I l 1 1 I / or Certificate of Coverage No.: NIC/Gl 0131 [7/ U/ Ul UI
Facility Name:
County:
Inspector:
Date of Inspection:
Time of Inspection:
Total Event Precipitation (inches): 01 �( S—
All permits require qualitative monitoring to be performed during a "measurable storm event."
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site
outfalI. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm
interval does not apply if the permittee is able to document that a shorter interval is representative for
local storm events during the sampling period, and the pennittee obtains approval from the local DEMLR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. C5c;,_ Structure (pipe, ditch, etc.): AP-W f
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
im&As-&� XIA � r-i`t to Ik. � --
Pagel of 2
el-
t-ULJ-`
5 WU-242, Last modified 06/01/2018

2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: i r c L 4- 1 ✓ VV vt
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): h,oyte-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy: �--c
1 (2 � 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
l.:/ 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where i is no solids and 5 is extremely muddy:
1 0 3 4 5
7. Is there any foam in the stormwater discharge? O Yes • No.
8. Is there an off sheen in the stormwater discharge? OYes ANo.
9. Is there evidence of erosion or deposition at the outfall? O Yes • No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe 001 (_
Note: Low clarity, high solids, and/or the presence of foam, oil sheen., or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
sWU-242, Last modified 06/01/2018