NCG060310 DMR SW

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL. PERMIT NO. NCG060000 SAMPLES COLLECTED DURING CALENDAR YEAR:
CERTIFICATE OF COVERAGE NO. NCG06 e2,�%® (This monitoring report is due at the Division no later than 30 days from
the date the facility receives the sao�plin results from the laboratory.)
FACILITY NAME �i tW,5 14 - COUNTY f�
PERSON COLLECTING SAMPLE !'�� PHONE NO.
CERTIFIED LABORATORY Lab #
Lab # PLEASE SIGN ON THE REVERSE 4
Part A: Specific Monitoring Requirements
Outfall
No.
Date
Sample
Collected,
mo/dd/ r
00530
00400
00340
00556
31616
Total Suspended
Solids,
m
pH,
Standard units
Chemical Oxygen
Demand,
m
Oil and Grease,
mg/L
Fecal Coliform,
Colonies per 100 ml
Benchmark
-
100
Within 6.0 — 9.0
120
30
1000
z
z,
, &
zz
ZY,
Wo,
ote: I f you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier I or Tier 2 rasp es.
See General Permit text. RECEIVED
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 Ti- Vehicle Maintenance Activity onitorino Re uirements
MAR 0 5 2015
CENTRAL FILES
DWF SECTION
Outfall Date 00556
No. Sample Collected, OR and Grease,
mo/dd r m
00530
Total Suspended Solids,
m
00400
pH, New Motor Oil Usage,
Standard units Annual averse 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 impiement i ter i or t ier 2 responses.
See General Permit text.
STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Division of Water Quality
Date Z. (first event sampled) �� Attn: DWQ Central Files
Total Event Precipitation (inches): 1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Date (list each additional event sampled this reporting pe0od, and rainfall amount)
Total Event Precipitation (inches):
S WU-249-102107
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"_,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)
,;?1A(v,5-
(Date)
S WU-249-102107
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