HomeMy WebLinkAboutNCG120066 - DMR SW (3) , ..t
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STORM WATER DISCHARGE OUTFALL(SDO) I .
MONITORING REPORT
Permit Number: NCS Nc-G Pzhon c or REC-E-kuis-T,),
......3 COLLECTED DUILING CALENDAR YEAR: yr_Le ZO1 5
Certificate of Coverage Number: NCG D6 to(.) AUG 2 fiTkiwonitoring report shall be received by the Division no later than 30 days from
it 161tilite the facility receives the sampling reqults from the laboratory.)
FACILITY NAME 1 i '''S a t..t . „" eS0 t CA .. r, CENTRAL FILES COUNTY I e3
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PERSON COLLECTING SAMPL al S) . hIfirra= ) ■ SECTION P wiNEIN0.0.0
CERTIFIED LAJ3011ATORY(S) .., A Y1C1 Illfra2 Lab# RIO& ' . ,
Lab# (SIGNATURE OF PERNITAIE OR DESIGNEE)
. • By this signature,I certify that this report is accurate
complete to the best of my knowledge. .
Part A: Specific Monitoring Requirements i) •
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Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?—yes no 1
(if yes,complete Part B)
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Part B: Vehicle Maintenance Activity Monitoring Requirements : ..
Outfit!!., . Date. '''',.':'1 ....;',.;. 5 50050'''"'''::;')' ..''..'• 1' .;•':)' 1,!:' '.. ..,'':2 ''.00856n,ti:::; •'; ; "i.•';:, f::.,;•':::!:,;!. ..'.'.' ...? 00539.',.,.,-' 4.y..':',...f'i.L'if.-• 00409.:.` '.7..':;;-...,:''''..:'i: '' ' .. •: /...':.'' ... ! '
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Form SW-U-246-062310
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Page 1 of 2
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STORM EVENT CHARACTERISTICS: Mail 1 riginal and one copy to:
Division of Water Quality
• 2� i 5 1 Attn: t entral Files
Date r /tin Q � 1617 all Service Center
Total Event Precipitation(inches): Ra1 ,North Service
Carolina 27699-1617
Event Duration(hours): (only if applicable—see permit.)
4
(if more than one storm event was sampled)
Date '
Total Event Precipitation(inches):
Event Duration(hours): (only if applicable—see permit.) dir•"I certify,under penalty of law,that this document and all attachments were Prepared form mysdb ection.1 rsupe vision in in accordance
the person
system designed to assure that qualified personnel properly gather and evaluate >I
or persons who manage the system,or those persons directly responsible for gathering the information,the ormation submitted is,to the best
of my knowledge and belief,true,accurate,and complete. I am aware that there are significant penalties fir submitting false information,
including the possibility of fines and imprisonment for knowing violations."
J4M0.1^'1 (Date)
4 (Signature of Permittee)
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'I Fond SWu-246-062310
Page 2of2
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STORMWATER DISCHARGE OUTFALL(SDO) I .
• MONITORING REPORT 1
Permit Number: NCS Ns✓G 1 Q1)Od C) or SAMPLES COLLECTED DURING CALENDAR YEAR: 26 I
Certificate of Coverage Nwuber: NCG D O/0 (This monitoring report shall be received by the Division no later tha 30 days r nl
the date the facility receives the sampling results from the laboratory.
FACILITY NAME �►I kes Cnu n a( id V2sic- • COUNTY a t� �'�
PERSON COLLECTING SAMPL.4 5) . is ..t. a.+. .r P LVO. 1. Z .
CERTIFIED LA13OItATORY(S) 'i. - -i V1Q N= Lab# Iff` • �,,
Lab# (SIGNA7 OF PERMITTEE OR DESIGNEE)
• By this signature,I certify that this report is accurate
complete to the est of my knowledge. • •
Part A: Specific Monitoring Requirements . •
..
• Outfall D
ate' •: r 5 0050:. n �!. ,.:,' x t "�.,.;, .. 7 .c•: ]: ti..✓«:: ..,:4.;n"• ..;a,::•-7r I;,t i ea h.�i..ir..f:ai.:to t ; i; : b M.,x• `:
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iNo. Sa I e T ntai #r .T tai•' r c qdq a.�. r� ; c.,q7 „ tt-.: '•.;. i �t;4s a.i'lA1 M '' 4 � I:� 121, .>.;i� :;i - ys• .•
Collected Plow if.tpp) ^ a a l �' • ,• ,.'if: ;' J -; , •; - r, �. , , i ,, a Z ..:', Y
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'I DWR Stun() 11111111 .
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?—yes ino 1
(if yes,complete Part B)
i
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall . Date 50050 i ,q r. t A055 iM r.•.r I ., ! c ,` ::00 530 •,;, ?;�..i 00400 .. :r:
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Sample ' .Tot l Flow•' .. a t 1 infall` .0 &Great .17 ,Non pola ' Tvlal> ` `� `' 1 1!
No. - a a Rra � a` r � ,��, ,. r p : ',..+�..: New,Mutor Oil
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Collected (if applicable) ,r°, `,. '(l`apps.) !,} FK '<. ;0&G/ kI�r" ,Suspended+ ,? ;r ,"�,, II g
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Form SWU-246-062310
Page 1 of 2
I
Mail 1 riginal and one copy to:
1 STORM EVENT CHARACTERISTICS: Divisi n of Water Quality
Attn: `entral Files
Date �� ' ` ` .2—° I 1617 all Service Center
Total Event Preltation(inches): Raleig i,North Carolina 27699-1617
Event Duration(hours): (only if applicable–see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation(inches):
Event Duration(hours): (only if applicable–see permit.)
1
under penalty of law,that this document and all attachments were prepared under i n sdb ection.;i rsupe vi ion in accordance
the person
I cemify, p Y
system designed to assure that qualified personnel properly gather and evaluate the informs
or persons who manage the system,or those persons directly responsible ft there are the
fiinfnr information,the,
f r submitting tiou submitted is,to the best
of my knowledge and belief,true,accurate,and complete. I am aware
including the possibility of fines and imprisonment for knowing violations." ,_ ,,,,-
gyp.►, (Date)
(4,
gnature of Permittee)
f.
1
1
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Form SWU-246-062310
Page 2 of 2
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