NCG060186 DMR SW (2)

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG060000 SAMPLES COLLECTED DURING CALENDAR YEAR:
CERTIFICATE OF COVERAGE NO. NCG06_ 0 (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.)
FACILITY NAME 6t%- r� LLL E+�EIVED COUNTY Su r t�
PERSON COLLECTINSAMP ES �� re.�• ...�► PHONE NO.
CERTIFIED LABORATORY Lab # JUN 2 9 2015
Lab # PLEASE SIGN ON THE REVERSE 4
Part A: Specific Monitoring Requirements
CENTRAL FILES
'DWR SECTION
Outfall Date
00530 �; :. ,
;'t ' 00400
4
,eti
,1;. OQ'SSdra•;,, ":; ;;. 1.;,=3'1616
No.
i;' JI: Sample. ^
u1• .Total'Suspend¢d'',�� .r'
'.,
i�;;,:;'" "�'' H,` -
�, 4,' P . ,...
, Chcml(!ol'.O gyp.
Oil',and. f ' 1,,.,
.r ,Grease, : i • 'Fecal Coliform, .
nipllected'
1� , r ',
_ :,
Soliil� . _ r, �•'
-'
'l
.., ,
� ;tiu,�'tarldard' units
' ',• �fC•
., , ,1 iT,.,
1)emaitri :•�.. ,
i �M
, „I
Yi�pl//,1 , ','� I,,, :;
1 YlO'^.�,. ',.',oldnies,ppr�lQOm1_
' mo/dW r .i4'
dl
- .^� /� ,. 1'.
i1J�' f1J
1
.'�'.I. ,. :•�� I�•' IL, 1.
�.J
., li 1•I
I ^i,.Ill' ''IMS'^i•�•4 ,�,1!�
•
i�l.�i .•
'1�'••,F •S I I ' _-
_
Benchmarkk,
,' ;�•' �..
a, .�
•,,„'.W` h'' �'' —.9'.0`-20--
tt tri',, .0
of
1000
do — i
Q to
0I
a
1T-`-- Tc----
,Nuie. a you repon a sampled value to excess or me 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 Monitorine Requirements
Outfall,
No:
Date'
$ample Collected;
mo/dd/' r ;
: _ 00556-1,-,-,-..--,,%00530
„Oil and,Grease;1.
; '
Total Suspended Solid's, '1
•:Sfit
-00400-'j,.,.
New Motor Oil Us
' PH'. ;i age,
ard'•,units •Anuual'avera a al/mo
Benchmark-'
:6;0.—•9:0';a: -
A T_a_- TC____. _
ivuto: a you report a sampled value to excess or 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:
Date (first event sampled)
Total Event Precipitation (inches):
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Mail Original and one copy to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
ct1/TT 1A0 IA -IIA -1

"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."
(Signature of Permittee) (Date)
SWU-249-102107
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