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HomeMy WebLinkAboutNCG060323_DMR_20231228GENERAL PERMIT NO. NCG060000 CERTIFICATE OF COVERAGE NO. FACILITY NAME PERSON COLLECT G S CERTIFIED LABORATORY Part A: Specific Monitoring Requirements STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT c� SAMPLES COLLECTED DURING CALENDAR YEAR: 7.L - 4 S (This monitoring report is due at the Division no later than 30 days from the date the facility receives the mpH esplts from t e laborato C, COUNTY �tY.0G . &t.*w er y ry) PHONE NO. (Y/a) # - f PLEASE SIGN ON THE REVERSE -> Outfall No. Date Sample Collected,: nio/dd/yr 00530 00400 00340 00556 31616 Total Suspended Solids, - - mgfL pH, Standard units Chemical Oxygen Demand, mg/L Oil and Grease, me/L Fecal Coliform, Colonies per 100 nal Benchmark - 100 Within 6.0-9.O::.r 120 30 1000. 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 -...Outfan No. - Date Sample Collected, mo/dd/vr.. 005S6 00530` O11400 Oil and Grease, m /L Total Suspended Solids, mg/L pII; ..Standard units New Motor Oil Usage, '.Annual average al/mo Benchmark 30 100 6.0 - 9.0 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: //-Z2- 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 C 0 r� t::3 4, rn h C" S WT T-740-1011 n7 J s- Stormwater Discharge Outfall (SDO) ` Qualitative Monitoring Report Permit No.: NICI I�I�I ®/ CIl 0/ D/ or Certifi to of Coverage No.: N/C/G/0/ Ib l / ! 11 Facility Name: r' - County: Phone No. Inspector: Date of Insl By this sjVQt I certify that this reporryr's accurate and complete to the best of my knowledge: (Signaturelof Permittee or Designee) 1. Outfal] Description Outfall No. tructure (pipe, ditc etc.) Receiving Stream: z�d A�' G Describe the industrial activities that occur within the outfall drainage area: 2. Color Describe the color of the discharge using basic colors dark) as descriptors: gown, blue, etc.) and tint (light, medium, r I 3. Odor Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc,) 4. Clarity . Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy: 1 2 3 4 5 6 7 8 9 10 Page 1 SWU-242-020705 5. Floating Solids Choose the number which best describes the amount of floating solids in the stormwater discharge where 1 is no solids and 10 is the surface covered with floating solids: 1 2 3 4 5 6 7 8 9 10 6. Suspended Solids Choose the number which best describes the amount of suspended solids in the stormwater discharge where 1 is no solids and 10 is extremely muddy: 1 2 3 4 5 6 7 8 9 10 7. Foam Is there any foam in the stormwater discharge? Yes CN6) 8. OR Sheen Is there an oil sheen in the stormwater discharge? Yes No 9. Deposition at Outfall Is there deposition of material (sediment, etc.) at or immediately below the outfall? Yes 10. Erosion at Outfall Is there erosion at or immediately below the outfall? Yes N 11. Other Obvious Indicators of Stormwater Pollution List and describe __ Al Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion may be indicative of conditions that warrant further investigation and corrective action. Page 2 SWU-242-020705 Cft %A1'4$�q a � . _ A Stor water Discharge O utfall (SDO) Qualitative Monitoring Report Permit No.: NI J/D/ 4101®/ 4/D/ or 'f'ficate of Coverage No.: N/C/G/ Ol & Ib 1712-I f I Facility N ` �V•� r County: L * Phone No. O �' Inspector. • Date of Inspection: By this sia certify that this report is accurate d complete to the best of my knowledge: (SignafDWW Permittee or Designee) 1. Outfall Description Outfall No. Atructure (p Receiving Stream: Describe the industrial activities that 2. Color Describe the color of the dark) as descriptors: 3. Odor Describe any i etc.) etc.} 4, ' S�- using basic colors (red, brown, blue, etc.) and tint (light, medium, A w / '/ e t It rf� that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, 4. Clarity Choose the number which best describes the clarity of the discharge where I is clear and 10 is very cloudy: 1 2 3 4 5 6 7 8 9 10 Page 1 , SWU-242-020705 r �. Floaft Solids Choose the number which best gibes the amount of floating solids in the stormwater discharge where I is no solids and 10 is the surface covered with floating solids: } 3 4 5 6 7 S 9 10 6. Susgend Solids . Choose the number which best describes the amount of suss solids in the stonnwater discharge where I is no solids and 10 is extremely muddy: 1 2 3 4 S 6 7 g 9 10 7. Po Is there any foam in the stormwater discharge? Yes 00 t� g. OR Sheen Is there an oil sheen in the stormwater discharge? Yes o 9. DeposWon at Outfall Is there deposition of material (sedsnwnt, ems.) at or immediately below the o tfall . YesCNo 10. Erosion at Mall Is there erosion erosion at or imatsdiately below the ouifall? Yes o 11, melons Indicators of S waiter PoDudon List and descriU Note: Low clarity, high solids, and;or the prewam of foam, oil she= position or erosion may to eve of conditions that wanes fiff&cr investigation and coffeetive action. Page 2 SWU 242-0 0705 0 AT, Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report . Permit No.: NVQIJJIM410101 A/ Dl or Certificate of Coverage No.: N cQ o-4I-1 t 1 —ILL/ Facility Name: r County: ��� n� Phone No. q / Inspector: 56 tT I r'' 4 Date of Inspection: -- g •- 2 3 By this sip, e, I certify that this report is accurate and complete to the best of my knowledge: ft (Signature bf Permittee or Designee) 1. Outfall Description Outfall No. . Receiving Stream: Describe the industrial activities that occur within the outfall drains /'.. -. r--A .-, </ n L V% "01 _ " e-area: ' 1 2. Color Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: _ � 3. Odor Describe any distinct a etc.) a the discharge may have (i.e., smells strongly of oil, weak chlorine odor, 4. Clarity Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy: 1 3 4 5 6 7 8 1 10 a Page 1 > SWU-242-020705 e �. Floating Solids Choose the number which best describes the amount of floating solids in the stormwater discharne where I is no solids and 10 is the surface covered with floating solids: I ".�z 3 4 5 b 7 g 9 10 6. Sus. d Solids . Choose the number which best describes the amount of suss solids in the storrnwater discharge where I is no solids and 10 is extremely muddy: D2 3 4 5 S 7 g 9 10 7. loam Is there any foam in the stonmwater discharge? Yes ONo 8. OR Sheen Is there an oil sheen in the stormwateter discharge? Yes No 9. Dep"ition at OWA YesONOIs there deposition of a�►teaW Gent, etc.) at or immediately below the mil? 10. Erosion at OWS Is there erosion at or immediately below the outfall? Yes N 11. Otha Obvim Indicators of Sturm Pollen List and describe Note: Low clarity, high solids, and/or the pmrim of foam, oil she= depodtion or erosion may be indicative of conditions that wait finer investigation and corrective action. Page 2 .J SWU-242-00705 J► 8 %A P-1 Stormwater Discharge Outfall (00) " Qualitative Monitoring Report Permit No.: N/G 10/ Dl 0/ Dl or Certificate of Coverage No.: NIC/G/ 0/ 14—1 r121I? 1 Facility Name: 02 Z-1 4 44,11 E e" County: W P 1; Phonel4o. 47� � � Inspector. - Date of Inspection: ` By e, I c 'fy that 's report is accurate and complete to the best of my knowledge: (Signature of ierrnittee or Designee) 1. Outfall Description Outfall No. Structurej pipe, 'tch, etc.) Receiving S nrA Describe the industrial activities that occur within the outfall drainage area: 2. Color Describe the color of the discharge using bas'c colors (red, brown blue, etc.) and tint (light, medium, dark) as descriptors: 4 19 - ve. 0e, f I �r 3. Odor Describe any etc.) _ irs that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, 4. Clarity Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy: 1 2 3 4 5 6 7 8 9 10 Page 1 SWU-242-MO705 S. Mating Solids Choose the number which best describes the amount of floating solids in the stormwater discharge where I is no solids and 10 is the surface covered with floating solids: 1 3 4 5 6 7 g 9 10 6. Sde4 Solids Choose the number which best describes the amount of suspended solids in the stormwater discharge whe7/2 'solids and 10 is extremely muddy: 3 5 6 7 g 9 10 7. Foam Is there any foam in the awmwater discharge? Yes No g. Oil sheen Is there an oil sheen in the stormwater discharge? Yes o 9. Deposition at Out&V Is tyre deposition of morial (ent, etc.) at or imnmliately below tine mddl? Yes No 10. Erodon at OBW Is there erosion at or immediately below the oatfall? Yes 6No Otw Obvkms InMadws of Sturmwder POBu*n L'st and descn'be n Note: Low clarity, high solids, and/or the paw= of foam, oil sW= depwition or erosion may be eve of conditions that warrant Mier investigation and corrective action. Page 2 SWV 242-MO705 E: WA �i Stormwater Discharge OutfaIl (SILO) " Qualitative Monitoring Report . Permit No.: NICI, I !�,l 0I 0! 4I l or Certificate of Coverage No.: NICIGI 0/ lb l 1 1 1 Facility N e+ ✓' Wei Ot County: 41 hone No. l Z Inspector Date of Inspection: ;ignatu'e this se, I certify that this rt is -accurate and complete to the best of my knowledge: rf Permittee or Designee) 1. Outfall Description Outfall No. Receiving Stream: Descri industrial activities that occur within the outfall drainage area: 2. Color Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: r, 3. Odor Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.) Ot Igh 1. a l 4. Clarity Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy: 1 03 4 5 6 7 8 9 10 Page 1 ; SwU-242-02C 705 �' 5. Floating Solids Choose the number which best describes L%e amo mt of floating solids in the stormwater dischage inhere 1 is no solids and 10 is the surface covered with floating solids: I *Z 3 4 5 6 7 8 9 10 b. Suslaend Solids Choose the number which best describes the amount of suspended solids in the stormwater discharge where I is no solids and 10 is extretrtely muddy: 2 3 4 S 6 7 g 9 10 1 0 7. Foam Is there any foam in the stormwater discharge? Yes �. Oil Sim Is there an oil sbeen in the stormwater discharge? Yes N 9. Demon at ©atfall Is there deposition of material (seiiatent, etc.) at or . iately below the outfall? Yes No 10. won at i Is there erosion at or immediately below the outfall? Yes No 11. met Obvkm Indicators of St0rMWMer Pollution Note: low clffity, high solids, and/or the PUB= of foam, oil sheen. dePosition or erosion may be indicative of conditions that wanes fiutlW investigation and corrective action. Page 2 J R L -M-00705 0 C;Lf %Ar4t > ?E _ A i Stormwater Discharge Outfall (SDO) ` Qualitative Monitoring Report Permit No.: N/G IQIA/ Ql 9>1 �/ �1 r Ce ' �cate of Coverage No.: NIGG/ 0l 16 / Facility Name: G. �' County: Phone No. `a Inspector: �. Date of Inspection• By this si , I certify thax L(Signaiiue of Pbrmittee or D 1. Outfall Description Outfall No. 6Str Receiving Stream: Describe the induotrial activi 2. Color Describe the color of the dark) as descriptors:., Drt is accurate and complete to the best of my knowledge: ire (pike, ditch, etc.) It W that occur within the outfall drainage area: using basic colors (red, brown, blue, etc.) and tint (light, medium, 3. Odor Describe any t odors that the discharge may have (i.e., smells strongly of dil, weak chlorine odor, etc.) 4. Clarity Choose the number which best describes the clarity of the discharge where I is clear and 10 is very cloudy: 1 V2 3 4 5 b 7 8 9 10 Page 1 ; SWU-242-020705 • S. Mad= Solids Choose the number which best describes the aaxm of floating solids in the stormwater discharge where 1 is no solids and 10 is the surface covered with floating solids: } �2 3 4 5 b 7 g 9 10 _ 6. Suspende4 ids Choose the number which best describes the amount of suspended solids in the storrnwater discharge where 1 is no solids and 10 is extremely muddy: 2 3 4 5 5 7 8 9 10 1 0 7. Foaffi Is there any foam in the sionnwater discharge? Yes N B. OR Sheen Is there an oil sheen in the stormwater discharge? Yes No 9. Depn at ®Mall Is there deposition of material (sedixr-nt, etc.) at or immediately below the otd91? Yes No 10. Erosion of OutfkH Is there erosion at or immediately below the autfall? Yes No 11,Other Obvkm1ndicators of stermweter Ponution List and describe ------------- Note.- Low clarity, high solids, armor the pmam of fog, oil shem deposition or erosion may he indicative of conditions that wama fun cr investigation and corrective action. Page 2 SWU 242-MO705 �► . WAr Stormwater Discharge Outfall (ADO) Qualitative Monitoring Report . Permit No.: NICI I I `I ®/ C1l 4l Dl or Certificate of Coverage No.: NIC/G/ 0/ lb 2 I I Facility Name: County: Phone No. inspector.�L— Date of inspection:; �. By this si , I certify that .�eport is accurate and complete to the best of my knowledge: / . "l (Signatiftf Pennittee or Designee) 1. Oudall Description Outfall No. Structure (p}pe, ditch, etc.) / Receiving Stream: Oe /��/ Describe the industrial activities that occur within the outfall drainage area: 2. Color Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: • 3. Odor Describe any distinct odors that the discharge may have (i.e., smelIs strongly of oil, weak chlorine odor, etc.) it 4. Clarity - Choose the number which best describes the clarity of the discharge where I is clear and 10 is very cloudy: 1 2 3 4 5 6 7 8 9 10 Page 1 • f, SWU-242-MO705 } e g. Floating ids Choose the number which best describes the amount of floating solids in the stormwater discharge where I is no solids and 10 is the surface covered with floating solids: D1 �2 3 4 5 6 7 g 9 10 b, Suqmde4 Solids Choose the lain which best describes the amount of suspended solids in the stonnwater discharge where I is no solids and 10 is extremely Muddy: 1 2 3 4 5 6 7 g 9 10 7. pion Is there any foam in the stormwater discharge? Yes No g. OR Sheen Is there an ail sheen in the stormwater discharge? Yes No 9. DepoMM at OU" Is tlae deposition of tnmrha (sediment, etc.) at or immediately below the ou fall? Yes No is dim erosion at or y below the outfall? Yes No lI.OthaObviom Indkators of Stwmwater Pollution List and describe Note: Low clarity, high solids, and/or the pmmw of foam oil sly deposition or erosion may be indicative of conditions that warrant fir investigation and corrective action. Page 2 SWU 242-02 O � a- Stormwater Discharge Outfall (SDO) QuaUtative Monitoring Report Permit No.: N/C *'a4 010/ 4 &l -- A rtificate of Coverage No.: NICQ Ol & Ib-171k I ,-I Facili Name: County: : Phone No. a Inspector. t C f (u f L �- Date of Inspection: C. IQ " 7 -g By this si e, I certify that is report is accurate and complete to the best of my knowledge: tow - (SIgnatfireW Permittee or Designee) 1. Outfall Description Outfail No. 46�S'� cture (pipe, ditcetc.) • Receiving S �/ ,,CCSS a • Describe the industrial activities that occur within the outfall drainage area: 2. Color Describe the color of the disch5ge using basicL rs (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: 04= ; 3. Odor Describe any etc.) odors that th discharge may have (i.e., smells strongly of oii, weak chlorine odor, ;t 4. Clarity Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy: 1 2 3 4 5 6 7 8 9 10 Page 1 , SWU-242MO705 � S. Floatiarg Solids Choose the number which best describes the amount of floating solids in the s ormwater discharge where 1 is no 'ds and 10 is the surface covered with floating solids: l ��Z 3 4 5 6 7 8 9 10 �. SUSA . ids 4j Choose the number which best describes the amount of suspended solids in the stormwater discharge where 1 is no solids and 10 is extremely muddy: l 2 3 4 5 6 7 g 9 10 7. Foam Is there any foam in the stormwater discharge? Yes No 0. OO Sheen Is there an oil sheen in the s1 11 water discharge? Yes o 9 Dew at OutM Is there deposition of nawial Cs nt� etc.) at or immediately below the outfall? 10. Fxodidn at OUdA Is there erosion at or immediately below the WWI? Yes 6No 11. Other Obvi= Indkators of Stormw8ter Pollution 4 Yes No Note: Low clarity, high solids, art&or the pM= of foam, oil sheen, dposition or erosion may be indicative, of conditions that wanwd further investigation and conective action. Page 2 SWV 2 2-020TOS *Ar -i A Stormwater Discharge Outfall (00) Qualitative Monitoring Report Permit No.: N/9f 0 4 / 0l_0l / &l or Certificate of Coverage No.: N1CQ S 94YP2 /.� l Facility N e: County: 70Phone No. Inspector. - jig C& J�L&C -jd2;1- 9= Date of inspection: By this s' e, I certify that this report is accurate and complete to the best of my knowledge: (Signature of Permittee or Designee) 1. 4utfall Description Outfall No. Siructure ipe, ditch, etc.) g �r Receivin Stream: il % AJ Describe the industrial activities that occur within the outfall drainage area: 2. Color Describe the color of the discharge using basic col s (red, bro n, blue, etc.) and tint (light, medium, dark) as descriptors: ' 3. Qdor Describe any distiAt odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.) 7i e 4. Clarity - Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy: 1 2 3 4 5 6 7 8 9 10 Page 1 SWU-242.020705 S S. Floating Solis Choose the number which test describes the a=mt of floating solids in the stormwater discharge where 1 is no solids and 10 is the surface covered with floating solids: 1 ,2 3 4 5 6 7 8 9 10 b. Suspende4 Solids Choose the number which best describes the amount of suspended solids in the stormwater discharge where 1 is no solids and 10 is extremely muddy: 2 3 4 5 6 7 9 9 10 Ow— 7. am Is there any foam in the stormwater discharge? Yes PO zz S. oil Sheen Is there an oil sheen in the stormwater discharge? Yes ONo 9. DepmWon at OutfA Is there deposition of � (�� etc.) at or immediately below the mdall? Y No ffl. Fkaeon at OWM Is there erosion at or immediaeiy below the outfatll? Yes No 1f,Odler Obviow indicators of Stmrmwater Pollution List and describe Dote: Low clarity, high solids, and/or to presence of foam, oil sheen.&pmuon or erosion may be indicative of con&dons that want fintber investigation and convx:tive aeon. Page Z 0 WAT4 a A i - Stormwater Discharge Outfall (00) Qualitative monitoring Report Permit No.: N191 j Dl 0l 4/ Dl or Certificate of Coverage No.: NICQ 0l —6A6l 7/ 2 / L1 Facility N t ri r County: e:OAZ z a Phone No. Inspector. _l u .4.$ Ic f / f L�r' G A- Date of Inspection: By this g�ature, I certify t�Pthis report accurate and complete to the best of my knowledge: -(Signature of Permittee or Designee) 1. Oatfali Description Outfall No. — Structure (pipe, ' am: tch, etc.) r Receiving Strer Describe the industrial activities that occur within the outfall drainage area.: 2. Color Describe the color of the dark) as descriptors: _ 3. Odor Describe any etc.) using basic colors (red, brown, blue, etc.) and tint (light, medium, G /10 "OgZ�1-1 a ad 7— that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, 4. Clarity Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy: 1 a 3 4 5 6 7 8 9 10 Page 1 SWU-242-020705 i noating SoUd Choose the nua*er which best describes the amount of floating solids in the stcrmwater discharge where 1 is no solids and 10 is the surface covered with floating solids: 4 3 4 5 6 7 g 9 10 fi. Suqmde4 Wds Choose the number which best describes the amount of suspended solids in the stormwater discharge where I is no solids and 10 is extremely muddy- 1 2 3 4 5 6 7 9 9 10 7. Foam Is there any foam in the stormwater discharge? Yes o S. Oil Sheen Is there an oil sheen in the stormwater discharge? Yes No 9. Dew at f3atfall Is there deposition of mat (sediment; etc.) at or immediately below the outfall? Yes No 10. - Fxoslon at OVdW Is there erosion at or imnwAiately below the oatfall? Yes No 11,O&w ObAous Indicators of Sto rmwaier Pollution List and descn'be Note: Low clarity, high solids, and/or &e Pau= of f0 m, oil sheen, deposition or erosion may to indicative of conditions that wanwa fuidw investigation and corrective action. Page 2 SWU 242-MMOS CO WA4fw 6 ?E Stormwater Discharge Outfall (Sly®) ' Qualitative Monitorig Report Permit No.: N1G ,1 l 4/ 01®101 D1 or Certificate of Coverage No.: FacilityName: L-+' r County: u At,* t Phone No. Inspector. e in r'1lr Date of Inspection: • r By this sigp4tiue, I certify t4p�thls fepo is accurate and complete to the best of my knowledge: (Signs'lure of'Permittee or Designee) 1. Outfall Description Outfall No. jl Structure ipe ditc etc.) Receiving Stream.4:�Ar &e f? /- Describe the industrial activities that occur within the outfall drainage area: g!2 2. Color . Describe the color of the dark) as descriptors: _ 3. Odor Describe any i etc.) ing basic colors ( d, brown, blue, %c.) sand tint (light, medium, A _ - _ 1 A. that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, 4. Clarity Choose the number which best describes the clarity of the discharge where I is clear and 10 is very cloudy: I 2 3 4 5 6 7 8 9 10 Page 1 . a• SWU-242-020705 � S. Floating Solids Choose the number which best describes the anxw of floating solids in the stormwater discharge where 1 is no solids and 10 is the surface covered with floating solids: 1 *�t 3 4 5 6 7 g 9 10 6. SUS. Solids Choose the number which best describes the amount of suspended solids in the storrnwater discharge where l is no solids and 10 is extremely teddy: Q08M 2 3 4 S 6 7 g 9 10 7, Is there any foam in the ammiwater discharge? Yes No g. OR Sheen Is there an oil sheen in the stormwater discharge? Yes No 9. Deposidon at Mail Is there deposition of g (fit, etc.) at or mmediawiy below the GOO? YeS No 10. Erosion at Ottfail there erasion at or immediately below the outfail? Y No 11.OtherObis Indicators of Stormwater Pollution List and descrf'be rJ Note: Low clarity, high solids, and/or the presence of foam, oil &been, depodt'on or erosion may be indicative of conditions that warrant fimher investigation and cOnUtive action. Page 2 8WU 242-MO7Q5 �► 0 �- Stormwater Discharge Outf (SJDO) Qualitative Monitor*ng Report . lalk 0/ A/ O/ Dl or Certificate of Coverage No.: Permit No.: ELCA Facility Name: Conn : Phone No. `7�• Z g L' t Inspector. Date of Inspection: - LOWOW By this signs , I certify that this report is accurate and complete to the best of my knowledge: Oe (Signature of Permittee or'Mesignee) 1. Outfall Description Uutfall No. Structure (pipe, ditch, e .) ,� ReceivingStream: t*v J A� Describe the industrial activities that occur within the outfall drainage area.. 2. Color Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: 3. Odor Describe any ' tint odors that the discharge may have (i.e., smells strongly of oil, wean chlorine Odor, etc.) 4. Clarity r Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy: 1/203 4 5 6 7 8 9 10 Page 1 SWU-242-MG705 ! Choose the member which best deribes ft amcunt of llaatiog solids in the-stm-Inwater discharge where 1 is no solids and 10 is the surface covered with floaft solids: 1 3 4 5 6 7 8 9 10 - 6. S Wds w Choose the nunter which best descri3 the amount of suspended solids in the s€ormwater discharge where I is w soles and 10 is e=emly may: y 1 2 3 4 5 6 7 8 9 i0 -. 17. Foams Is there any foam in the stormwatear discharge? Yes ONo a. Onsbeen Is there an oil sheen is the stormwatear discharge? Yes No 9. Demon at Is there ' ' of MdCZ $l font, etc.) at or' below the mil? Yes No 10. FxWW at Is there erosion at or elY below the o l? Yes No 11. Odwr ()bvkm Indkators of Stw=Mter laORUd n List and descnU Note: Low clarity, highsolids,and/ortheFMW of jbM Off , deposition or erosion MY be motive of cmftcm that wamnt f n*cs mvesdpt[on and cm emve action. Page 2 1. SWU 242-02M . 9 %Ar Stormwater Discharge OutfaU (SDO) Qualitative Monitoring Report Permit No.: N/Cl& 4,10/ 10l 4l Dl or Certificate of Coverage No.: Facility Name: j,W APL , County: L. t'IMI Phone No. r Inspector. M Date of Inspection: By this , I certify that report is accurate and complete to the best of my knowledge: (Signature of Pernuttee or Designee) 1. oaifall Description / Outfall No. Structure (pipe, ditch, etc.) 1 Receiving Stream: r' Describe the industrial activities that occur within the outfall drainage area: 2. Color Describe the color of the dischar ' using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: g==:f Z Z P- W == AZ 3. Odor Describe any distinct t odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.) fy &A�� 4. Clarity Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy: , 1 2 4 5 6 7 8 9 10 Page 1 SwU-242-MG705 � e 5. Floating Sous Choose the der which best describes the =o= of fluting solids in the-sto;mwater discharge where I is no solids and 10 is the surface covered with floating solids: 1 3 4 5 b 7 g 9 10 f. Susgende4 SoUds Y Choose the number which best describes the amount of suss solids in the stormwater discharge where I is no solids acrid 10 is extremely muddy: 2 3 4 5 5 7 g 9 10 7.2 Is there any foam in the gormwater discharge? Yes No S. oil Shams Is there an oil shwa is dz ammm ter discharge? Yes o 9. Depwition at OUW Is there deposition of mawAd ( etc.) at or' below the au&A? Yes ido g�. Fzodm at OuffM Is there wan at or i ely below the outfall? Yes Ado 11. QtbW ObTIM bdicators of Stamvatff Mt List and dew -- ' Note: Low ctm*Y , high solid an&c r the FMM of f A ail sly or erosion nmy be indicative of co�ditiow that wanes in&r invesbipfm and corrective action. Page 2 SWU 242-02M �►