NCG140390_DMR_20200729

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE N4 INC / V 3 " D
FACILITY NAME: y 6dQ,S1Wio o-n-i—
PERSON COLLECTING SAMPLES Q
CERTIFIED LABORATORY Lab #
Lab #
OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: a°
SAMPLING RIOD: ❑ July -December January -June
COUNTY U
PHONE NO.
ADD TO USTSERVE? DYES ❑NO EMAIL: //��
DISCHARGING TO CLASS: ❑SA FHQW ❑PNA ❑Trout Other LJ
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
1
NO FLOW)
PH
(Standard
Units)
TSS
(m�L)
Event
Duration
(minutes)
Total
Rainfall
(in)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in Tier
z
2 Sampling
-
-
6-9
' 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.
' 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.
3 TSS benchmark values are 100 mg/l, except when discharging to ORW, HOW, Trout, and PNA waters where they are 50 mg/I.
°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
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