NCG030224 DMR SW

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG030000 SAMPLES COLLECTED DURING CALENDAR YEAR: 2015
CERTIFICATE OF COVERAGE NO. NCG03 0224 (all samples collected during a calendar year, shall be reported no later
than January 31 of the following year)
FACILITY NAME Johnson Controls Battery Division COUNTY Forsyth
PERSON COLLECTING SAMPLE(S) Glenn Price PHONE NO. [phone]
CERTIFIED LABORATORY(S) R & A Laboratories, Inc. Lab # 34
Lab #
Part A: Specific Monitoring Requirements
(SIGNATURE OF PERMITTEE OR DESIGNEE)
By this signature, I certify that this report is accurate and
complete to the best of my knowledge.
Outfall
No.
Date
Sample
Collected
50050
00400
00530
01051
MG mg1l mgtI unit al/mo
Total
Flow
.,pH
Total
Suspended
Solids
Lead
Copper, Tot
Zinc, Tot
mo/dd/yr
MG
'unit
mg/I
mg/1
mg/I
mg/l
001
06/19/15
6.53
7.5
0.060
<0.005
0.047
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? —yes X no
(if yes, complete Part B)
Part R- Vohirta Maintpnnnrp Activity Mnnitnrina Rannirainantc
Outfall
No.
Date
Sample
Collected
50050 00556 00530 00400
Total Total Total pH' New Motor
Flow Oil and Suspended Oil Usage
Grease Solids
mo/dd/ r
MG mg1l mgtI unit al/mo
STORM EVENT CHARACTERISTICS:
Date 6/19/2015
Total Event Precipitation (inches): 0.12 Mail Original and one copy to:
Event Duration (hours): 1.5 hours Division of Water Quality
Attn: Central Files
(if more than one storm event was sampled) 1617 Mail Service Center
Date Raleigh,,NC 27626-1617
Total Event Precipitation (inches): N/A
Event Duration (hours): N/A
Copy of Form SWU-245-120399
Page I of 2

Footnotes:
Applies only to facilities at which fueling occurs.
2 Detergent monitoring is required only at facilities which conduct vehicle cleaning operations.
" 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 inquirey 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."
(Date)
-7,'-z ? - /
Form MR -18
Page 2 of 2