NCG190018 DMR SW (4)

CERTIFICATE OF COVERAGE NO. NCGI
FACILITY NAME %4RMY - M/H27i
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY 6AM,
Part A: Specific Monitoring Re uirements
STORMWATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG190000
DISCHARGE MONITORING REPORT (DMR)
a
Lab #
Lab #
RECL I V E®
SAMPLES COLLECTED DURING CALENDAR YEAR:
(This monitoring report is due at the Division no later than 30 days fW 4 2015
the date the facility receives the sampling results from the labora
COUNTY Pi A _D✓IR SECTIp S
PHONE NO. (2S 11) N M-2
Outfall Date
No. Sample Collected,
mo/dd/ r
TotalRahifall,
inch
00530
00400
00556
01119
01104
01094 01114
Total Suspended pH, Oil & Grease, Copper 7 , Aluminum
Solids Standard units
Zinc ' , Lead ,
m
Benchmark -
-
100
Within 6.0 — 9.0
30
0.007
0.75
0.067 0.03
# 3- O•is
O"
�
�2.
,
,0
D,010
40,100
(5.030 40,005
If a value is in excess of the benchmark, or
' Total recoverable.
3 These benchmarks are water hardness deoe
Mail original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION
"I certify, under penalty of law, that this
system designed to assure that qualified F
persons who manage the system, or those
knowledge and belief, true, accurate, and
possibility offi s and impriso ent for
a , — z gak—_
(Signature o ermittee)
the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit.
Values shown based on a hardness of 50 mg/L.
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit requirement
for managing solvents, I certify that to the best of my knowledge and belief, no leak, spill, or dumping of concentrated
solvents into the stormwater or onto areas which are exposed to rainfall or stormwater runoff has occurred since filing the
last discharge monitoring report. I further certify that this facility is implementing all the provisions of the Solvent
Management Plan included in the Stormwate Pollution Prevention Plan."
x.13, U
(S' tore of Per 'tee) (Date)
ANY INFORMATION ORTED:
it and all attachments were prepared under my direction or supervision in accordance with a
properly gather and evaluate the information submitted. Based on my inquiry of the person or
directly responsible for gathering the information, the information submitted is, to the best of my
e. I am aware that there are significant penalties for submitting false information, including the
violations."
-// .13
(Date)
Permit Date: M/l/2009-9/30/2014I SWU-253-092309
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