NCG020351_DMR_20230708

STORMWATRR DISCHARGE MONITORUNO REPORT (DMR)
I� Please Mail Original And One Copy To Mailing Address Below
GENERAL PERMIT NO. NCG020000
Part A: Facility Information
Samples Collected In Calendar Year: k 2 0 Z3 (all samples shall be reported within 30 days following monitoring period Certificate Of Coverage No. NCG02 )
Facility Name O3 County of Facility moi 'i t x r
C'� v'
Facility Contact 6 ✓ h 2 Name of Laboratory Gvg7E t•,
Facility Contact Phone No. — �- UPh okle 6-Q� V c .,ab Certification it # 5O
(�- - C' Yg-7
Part B: Land
Disturbance and Process Area Monitorin Re utrements
Outfall
No
Receiving Stream
Name
Date`
5605.0-
00530
00076
Saafple
Collected`
Total
Flow
Total!
Suspended„
Sollds.
Turbtdlty,:
Settleabley
Soilds..::
"I d/ � r
m
-Z
Part D: Storm Event Characteristics
Total Event Precipitation (inches): 0
Event Duration (hours): /2 —rxrUE wED
R4 CfiW ffecipitation (inches): _
Event I RiVion (hours)
JUL
if it 1 U 2023 V@5ate storm event is sampled)
Part E: Certification CE(N7•RA(, F
CENTRAL FILES DWR SECT LE`"
"I certify, under penalty of law, that this fA�{ida8g®>Fibd� attachments were preparedunder 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."
Part F: Mailing Address
(Signature of Permittee -- (Date)
Attn: Central Files, DENR, N.C. Division of water Quality, 1617 Mail Service Center, Raleigh, NC 27699-1617
SWU-