HomeMy WebLinkAboutNCG020351 DMR SWSTORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NC6 SAMPLES COLLECTED DURING CALENDAR YEAR: /
Co,t- <.o ue✓-tje. W -65O Z03C I (This monitoring report shall be received by the Division no later than 30 days from
CJ. the date the facility receives the sampling results from the laboratory.)
FACILITY NAME C A N Q) O R M l lU E
PERSON COLLECTING SAMPLE(S) 5-f42ven l3/Ce ti (��tib�4� r
CERTIFIED LABORATORY(S) Wofl2rfe-6, C.c.-%S Lab # 6D
Lab #
Part A: Specific Monitoring Requirements
COUNTY 1'h 0 W -G 6M E e T'
PHONE NO. (70`/) 3 W - fiy37
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
1 Date.Ii
NO" Sample
Collected
1
Total
ff. MW Rainfall•
•
�1•�® 0
r11 M11 R.
00530
00400
Total Flow
(if applicable) .
I
Total ..
'Rainfall(if
Oil & Grease
appl.)
Non -polar
O&G/TPH
(Method 1664
SGT HEM), if
app l
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/dd/ r
MG
inches ..
m /I
( _.
m /l
unit .gal/mo
Does 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 Activitv Monitorine Requirements
Outfall '
No;..,.,,, 1
y
Date
-Sample
Collected
50050
00556
ii
00530
00400
Total Flow
(if applicable) .
I
Total ..
'Rainfall(if
Oil & Grease
appl.)
Non -polar
O&G/TPH
(Method 1664
SGT HEM), if
app l
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/dd/ r
MG
inches ..
m /I
( _.
m /l
unit .gal/mo
Form SWU-247, last revised 2/2/2012
Page I of 2
STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Division of Water Quality
Date Z -9 -I ; Attn: Central Files
Total Event Precipitation (inches): 0,72- 1617 Mail Service Center
Event Duration (hours): (only if applicable — see permit.) Raleigh, North Carolina 27699-1617
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable see permit.)
"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)
0
Form SWU-247, last revised 2/2/2012
Page 2 of 2