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Parameter
Require
Code
for O m, ys AMR_�`^gents
utfalls With Industrial q
N/A
Parameter ctivitieS _
N/A Receiving Stream Bench
Dateam Class Outfall marks in
Sample (Red
46s29 mple Collected nSW Ouffaii �- )
C0529 T4-Hour Rainfall inMM/OD OuNall
Inches Outfall
COS30 SS in mR/L (10003/24/2022
PH in or SO*) 2.0
IIIIIIIIIIMmime
00400
78141 Total standard units 3�913.8
Total
1 Organicsoxic (if required) in
IIIIIIIIIIIN
010S1 Lead, total r
m: L 0.075 coverable (as Pb) in 46.0
770�3 Ethylene Glycol in 0.00� ftlilliftil
detected Tier One; � L (any amount
00552 and Three 00 mg/L Tier
Non-Polar <5.0
NCOIL Estimated Oil & Grease in mg/L 1
simum.....___
* putf Usage In gal/month
New Motor/Hydraulic 5, <6.2
ails to Outstanding
Oil
have a benchmark
Resource n/a
urCe waters
CDR
TSSnlimit of SO a waters
Arlo W)' High Quality Water
s (HQW), Trout
Notes classifications haveWaters (Tr)
�O tionai): a benchmark of 100 mand Primary Nursery Are
g/L
"I certify b
accordance my signature Belo
inquiry of the it era system designed dto Penalty of law, that this documentassure and all attachments
false information,' tO the best of who manage the s Properly gather and Were prepared under
including my knowledgesystem, or those evaluate the information my direr
g the and belief, true persons direct)
possibility true, and Y responsible for submitte
Y of fines and imprisonmentcomplete. I amgathering the inform
for knowing aware that there are significant at�or
g violations." gnificant pen
Sig ature of Permit
ee or ele - ed Authorized Individual
Email Address ma 12/08/22
M/t/aCilhallnr,,Y,ail (-elm
Dhnno N .+"" ,L,e. 7c7_O
.al Toxic Organics Certification:
sed upon my inquiry of the person or
sed upon
for total toxic organics or persons directly responsible for mana in co), I certify that to the best of m l g nd belief with the permit
.entrated toxic organics into the stormwater orY knowledge and bel
the last discharge monitoring report. I f onto areas which are exposed to rainfall1ef' no leak, spill, or
rum
further certify that this facility is implementing allo stormwater s of
we
Plan included i t Stormwater Pollution Prevention Plan."
3 ,
ure of Permittee or Dele e Authorized Individua 2108/22
,0
Date
I
address marywasilhall@gmail.corn
Phone Number 2524.