NCS000373_2022 DMR_20220317

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS000373
FACILITY NAME Michelin Aircraft Tire Company
PERSON COLLECTING SAMPLE(S) Heather Ashby
CERTIFIED LABORATORY(S) Pace Analytical Services Lab 4 PAS1-A
Lab #PASI-C
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 2022
(This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
COUNTY Stanly County
PHONE NO. 7( 04 }474-8136
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Outfall
Date
50050
5
00400
(00,640
No.
Sample
Collected
T taI
Flo if a
Total
Rainfall
Oil & Grease
pH
COD
moldd/ r
MG
inches
1
g'
f L
001
02/27/22
N
0.76
0
6.62
J1,9
002
02/27/22
0.76
0
8.01
0
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ()yes ono
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitorin Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total
Rainfall
Oil & Grease
(if appl.) .
Non -polar
O&G/TPH
(Method 1664
SGT-HEM), if
appl.
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/dd/ r
MG
inches
m /l
m /l
unit
al/mo
Form SWU-247, last revised 611212015
Page I of 2

STORM EVENT CHARACTERISTICS:
Date 2/27/22
Total Event Precipitation (inches): 0.76
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 Mail Service Center
Raleigh, North Carolina 27699-1617
"I certify, under penalty of law, that this document and all 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 the possibility of fines and imprisonment for knowing violations."
r
3119f)
(Signature of Permittee) (Date)
Form SWU-247, lost revised 611212015
Page 2 of 2