NCG140385_DMR_20210426

STORMIMATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE 0fGeVjRAGE NO. NCGi
FACILITY NAME: ' �Whn i�F
PERSON COLLECTING SAMP _/lt _
CERTIFIED LABORATORYbjj+_ _ Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater !Monitoring Requirements
SAMPLE COLLECTION YEAR: )
SAMPL RIO ❑ July- cember January -June
COUNTY nc
PHONE NO. [
ADD TO LISTSERVE? YES ❑NO EMAIL:
DISCHARGING TO CLASS: ❑SA [)�HQW ❑PNA ❑Trout ❑Other
Outfalt No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)I
pH
(Standard
Units)
TSS
(mg/L)
Event
Duration
(minutes)
Total
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
2 Sampling'
-
&9
100 ,
-
-
MAY 10 20PI
s
,1
1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit, Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
a TSS benchmark values are 100 mg/I, except when discharging to ORW, HOW, Trout, and PNA waters where they are 50 mg/I.
a For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

A - A
iT
i
3� O"l-I OT
_j
;DI
ZFAT iii u"
J.! lzmj
Ir
--- — ------
--- --------
isro"!
vis'i - i1i
.3oo-". Wi-iri :Y"
1w.
-� lo 1

v_va3
v a+
0Z"�
m
_
_
o° o
°�.��
o
0 o
d �'n� c
61 N
'a !6 ��' 3
;fn
CO CCi o Z
o o
��-'
°
O N N
^'
fD
O ='
m N
N -i
0 p Z
�•
p
3 a C
m N=
R
3� Gi
ani
N
N 3 N ra
cr
A fti
V
3om-, Z
r
A ..
=5 m
fAD @
+`m�'
p CL
c
�-'
C
0'�ay
p.eno'3?�O�
d md 7d
Na3
ca
coy+
p
M 11�
(d toe=t Z
,G
Z
ff
0 a s
O N N
4+ ~
N
14
m
N O S
cn
to
1�D
NJt�
m c
to 'p
O
.�
F•j
'
m Q O N
u,
o d 0
ID O N �.
0, O
p
41
m n C nr °
N~ 1 .J
V Z
N d .0 CL C
oKq CL y amy.,
���^2
N
fD m
4 o
iwS1c3
N:
•?
�Z
m FdN.�-�
0 I O
CL
e"i
G
-n�'
o
T^*= o
-
c tv 0*S A A
i0
�n a 3'
3 3
0
m o
o
y o
,r nj
n
O' '� A O
C
= C �•
A M
,..r a- p�j CL 00
O p C
si
m a+ m ao 0.
O o O
>
P
a CL
@ M
d a
-
N
3. a
c
0
3 , n 3
a CL
i
r
-% .+
CL o p a
C
o Q j� o m
V4
1 `° 3 a
Z
CL
a
Gm.+�_
oc�
or
c°
in
P a y o IN
-s V! N
8'
=
3 -00 N C
0 o M
41
'* m <
-
—� 0 06 Z
c d
pp
woa
of M
3 W p
w m
Ct 1
o.a
Z
on.
oph
A
W
o3i 7 =
Cc.
o .�-°" N m
O O
v c H
mom?
m03
gy p?
o
3 m
o A
in
A m
� aZ a°7o
m
O A O
� m R
M
M '^
m 3
a
5
CM
T
�M
ep
m
CL
CL1
cgm d
N
Ln
NJ
o
=`
ft N
N

Si.
s a
ULp
won
Imn WC lood": M� maw
0
Ojai &no
0 W, Mft
vol MUM M
; TMAO 45 VAD
W vt
W
M� i;:",
YAi in,
..v
m
"W"No Ada, jot a."
�Aw ON MCM4
Want&, 00, voon W, la"
fflJ
II
pn4 v )Vic
--77
T ow into tF OW4
. .04