NCG190018 DMR SW (2)

-,
.�+OF.
STORMWATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG190000
RECEIVED
MAY 2 2 20-15
DISCHARGE MONITORING REPORT (DMR) CENTR4L FILES
SAMPLES COLLECTED DURING CALENDAR YEAR: `�ORIIR SECTION
CERTIFICATE OF COVERAGE NO. NCGO10 0 /❑®
FACILITY NAME QR4AY —
PERSON COLLECTING SAM
CERTIFIED LABORATORY
Part A: Specific Monitoring Re uirements
Lab #
Lab #
(This monitoring report is due at the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
COUNTY pt R
PHONE NO. (24'ILJ 752 - 211)
Outfall
No.
Date
Sample Collected,
mo/dd/ r
Total Rah ifall,
inch
00530
Total Suspended
Solids
00400
pH,
Standard units
00556
Oil & Grease,
M91L
01119
Copper',',
m
01104
Aluminum
01094
Zinc ' ,
m
01114
Lead ' ,
m
Benchmark
-
-
100
Within 6.0 — 9.0
30
0.007
0.75
0.067
0.03
o*l Fa
14-1q.1
0.20
5
�
45.0
40.010
/_0.100
0.211
/_0,005
t Z �,bY
1
0, G la
19,056
1 0.00?
If a value is in excess of the benchmark, or
Total recoverable.
3 These benchmarks are water hardness deve
Mail original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SItuN THIS CERTIFICATION
"I certify, under penalty of law, that this.
system designed to assure that qualified F
persons -who manage the system, or those
knowledge and belief, true, accurate, and
possibility of fines,pnd imprisonmient for
(Signature of
the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit.
Values shown based on a hardness of 50 mg/L.
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit requirement
for managing solvents, I certify that to the best of my knowledge and belief, no leak, spill, or dumping of concentrated
solvents into the stormwater or onto areas which are exposed to rainfall or stormwater runoff has occurred since filing the
last discharge monitoring report. I further certify that this facility is implementing all the provisions of the Solvent
Management Plan inclu](a
e' the Stormwate Poliu n Prevention Plan."
galv
5 I l�r
nature of
"Per'puttee) (Date)
ANY INFORMATION ORTED:
tt and all attachments were prepared under my direction or supervision in accordance with a
properly gather and evaluate the information submitted. Based on my inquiry of the person or
directly responsible for gathering the information, -the information submitted is, to the best of my
e. I am aware that there are significant penalties for submitting false information, including the
violations."
5-hIf
(Date)
Permit Date: 10/1/200/30/2014I SWU-253-092309
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