NCG060329 DMR SW

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG060000
CERTIFICATE OF COVERAGE NO. NCG06
FACILITY NAME AICL35C GLC—
!<< -
PERSON COLLECTING SAMPLES / M _
CERTUgED LABORATORY,60Li! O 4QyEIY) Lab
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR:
(This monitoring report is due at the Division no later than 30 days from
the date the facility receives the s �p��reypits from the laboratory.)
COUNTY •t!
PHONE NO. (%JD I
118Cey9 V6aEASE SIGN ON THE REVERSE 4
MMR 11 2015
Outfall Date
No. Sample
Collected,
mo/dd/ r
00530
00400
Benchmark 30
00556
31616
Total Suspended
Solids,
m
pH,
Standard units
Chemical Oryg n
Demand,
m
Oil and Grease,
mg/L
Fecal Coliform,
Colonies per 100 ml
Benchmark -
100
Within 6.0 — 9.0
120
30
1000
7.
4nv
2 — x /S
3!
.o
z�
S"o 31',S
L
-.r�
z2
Note: Ifyou report a sampled value in excess of the bencnmarK value, or outsiae the oencnmarK range for prt, you must impiemem i mr i ur I ivi L iobNvnaw.
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) - .
D -..s D. X7..Li..11 M.. i..ae........e A..H..i+..
Outfall Date 00556
No. Sample Collected, Oil 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 bencnmarK value, or outsiae the oencnmarK range for PH, you must implement 1 ler 1 or 1 ►er a respuiww.
See General Permit text.
STORM EVENT CHARACTERISTICS:
Date (first event sampled)
Total L vent Precipitation (inches): . T
Date 01st each additional event sampled this reporting poilod, 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
S WU-249-102107
Pagel of 2

"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)
;2 r^
(Date)
S WU-249-102107
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