NCG060186 DMR SW

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG060000
CERTIFICATE OF COVERAGE NO. NCG06_ d 13(g
FACILITY NAME L j Fe. t s
PERSON COLLECTIN SAM LES m- W l:
CERTIFIED LABORATORY c,wi /} Lab # -3q
Lab #
Part A: Specific Monitoring Requirements
U L
JUL 2
2015 I
SAMPLES COLLECTED DURING CALENDAR Y MirT��G
(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 5 u trY
PHONE NO. C3 ) 3j,& -
PLEASE
g& -PLEASE SIGN ON THE REVERSE 4
Outfall Date 00530'0'4400 0,03p ;3'1616
,, i 2,i ,: �,..i: I ,I, '�ey� •aUQSS el�i 1,II '•�, ,Id• 'il. 'I,. ..
,�I--- C-. -' �,, �'i - : :,r. 9. 5`01,101d0�,„1''�. ��• ';'�'�� ��!' '�; i••i',�;:�P!"''„�,•�ti'��W:�'tt''Iat,li.I”ii�'id- npS,.H�C'd:',0'U'-II,_9it''.90�.� ;I•'C'Y,•a.tNo. ,r;• -.Total' Suspendod',i,fr' 'eyn ;i•I' .1
I.iland..i .•n �' �r,.,e
, a.,Ase)''-:11';,'-'Fecal C'
Coliform.
-r-'100
�nil,modalr Colbiies'p
Benchmark'
"'120 ,' '4�,,1„ '.,, , . i,,•e ''� �
,100 `•
0.
002
boa
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses.
See General Permit text.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? — yes no
(if yes, complete Part B) —
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall Date' ; : 00556 00530 '00,400 1
No: Sample Collected; ,..Oil and,Gre'ase; ,• Total Suspended Solids, :,- - pg;' I, New IVIotor Oil Usage,
�% m /4 $tandard'uuiXs An 'ual'
Benchmark ;; ''' .;� : ,3U n avers a al/mo
•ur.'• �r :, 100`'
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses.
See General Permit text.
STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Division of Water Quality
Date (first event sampled) Attn: DWQ Central Files
Total Event Precipitation (inches): 1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
CAUTT')AO in)in7

"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 pny 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." '
(Signature of
J11", C) I jJ
(Daiel
SWU-249-102107
Page 2 of 2