NCG120005 DMR SW (2)

STORMWATER DISC' IGE OUTFALL (SDO)
MONITORLtvG REPORT
GENERAL PERMIT NO. NCG120000
CERTIFICATE OF COVERAGE NO. NCG12 000 5
FACILITY NAME6 beS6 ii co, S6U 1J45'Te
PERSON COLLECTING SAMPLES -eAnVN
CERTIFIED LABORATORY TEL QlJOr4-�arH Lab #�_
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: �0/S
(This monitoring report is due at the Division no later than 30 days from the date
the facility receives the sampV fesults from the laboratory.)
COUNTY I ohe Sova
PHONE NO. (91/0 ) 9&S'- 3 3 g/
PLEASE SIGN ON THE REVERSE -)
..Outfi
Date `:"
l ;rk _:., •,003:40_ u >,'::, ,r:,� rt•�: �Fi, %<... , a ., _ .r . :;; :' -
316'16, s'j+,','_'T;.;•.,'= =,^R:> �+ yry 0530":.;
'•Np:;a
r;
=Sabi `le't:olle `,,,
p cted
,.
';,;. t �. �.�-11 .� ,.., _
;•C,heinica O"`': �n:De ari' „ - ., rs ' .,a1 5 :, .:r ,r;
a. ?' t. ,. -., ,5..•� . Fetal: Coliform' _..,.; ; . •e,..,� , "stalk (�
�i eia'ded'•S'ohds•'
•1.
^nio7dd%'r
,1w�•, _,':
i t:. ./ N<:-r�-f,_„• , d;.,. ';:"•: `},.:�
perI, (;:F;, y' rj; t r '•' a `:::::
Benclimarlf''',:'
>, . _
%120YI q •.1000=OIOtii�3a`"160
Dd
d Fla
S o t
ASO FIn
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Oo t
NntP• Tf vnn mmnrt
a cmmnl—1 .,el
___
t..-- •...,.,.... �013 .,. Lul- ucucu.uu.a vaiuc, yuu must implement 1 ter t or 1 -ter Z responses. See General Permit text.
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?'o
_yes
(if yes, complete Part B) -
Part B: Vehicle Maintenance ActivityMonitorin Re uirements
;•,Ogtfa(1`:Date'
.
, t..�'�;
"`''r�":0055C;,r;,,Vr,��..;4 t;;;; ,.; •4,"";0'0530'',,:;:
;,;
'5ample:Collected,'
i''Oil atidt, 'reo`se =�y; oal u3' en
s.'t "• ded;$olids pH';: i,• " i.i, ': ,:? NeW!Mol
'q`'i'.i•+pa5',�,k_R�
.; l?., x OII. Usage,
•1.
"rrlo/diU I' � -
;;,,t, fYilkY
� ii.. t;d.4 lJ `n5',,.�'�> .1. -
iI':(..r.L I,. I''\..� =•"' t'iti.,l�Ji�. "T�r'A,•:.{-. - .•"•.."r:.�.
•
-m ''m _ '<: Sta'ndard!units,`' •J' '_Avera a"antnual'
Benclimarlf''',:'
>, . _
:•i.`: �30F'i,,�;:i:,:.,�, n�r�,�-. ti. - .. _ . ,.a - gal/mo
NntP..• ifvnn rannrt
cpm I.A —1—
_raL_ L_�_L._-_-_f- _,-
�A
FEB 0 4 2015
Ce'%1 r �,
CwR ��CTjpN
_- �- ,,,,,�,r,,,�, -- ... cACCOa ul Luc vencnmarx value, oroutside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses.
See General Permit text.
STORM EVENT CHARACTERISTICS:
Date (first event sampled) Mail Original and one copy to:
Total Event Precipitation (inches): Attn: DWQ Central Files
NCDENR/ DWQ
1617 Mail Service Center
Date (list each additional event sampled this reporting period, and rainfall amount) Raleigh, NC 27699-1617
Total Event Precipitation (inches):
S WU-248-102107
Page i of 2

STORMWATER DISC' IGE OUTFALL (SDO)
MONITORL,4G REPORT
GENERAL PERMIT NO. NCG120000
CERTIFICATE OF COVERAGE NO. NCG12 0005 1
FACILITY NAME qI o6 .son C o. .So\gid 0,x0 Te
PERSON COLLECTING SAMPLES ' enk-sar, 2ocPrs
CERTIFIED LABORATORY 17QL L.06 r a?N,y Lab # 7-1_
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: �20/5-
(This monitoring report is due at the Division no later than 30 days from the date
the facility receives the sampUn stits from the laboratory.)
COUNTY 9,e t00
PHONE NO. ( 9/0) toS - 33'19
PLEASE SIGN ON THE REVERSE 4
_O.uXfall';'
Date 316:16 .*,'.,
No:..
>.;
Sam le Coll _ =`" a = :, ,,i ;r,
p _ ecfed ;;Cheiriicaf'(� en';De an °r; „
�' �.„ -�•. :, ', `';Fecal Coliform :,,;:,' r..., a • .' ;' �Totah
-, Sus`'ei de&Solids
.ii%- _
Oil ;a#idxredse; is o"a Sud' ended Solids
_ - "�;;-
'- �.I ,
,K �._. ,
1. ,, ..t .Y,..""'1,' -��� t;,• ,N.1,4.. 1, •ry,•,.�1. .,• , ,,,,. .Y. L - 1 -
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-
_•,
; '- .-M:s -, .1.F t
r /F;;, ,, n;,.;: ,.. '.,, r:
'':m
:ri�r' e
"Standard;units �;,4y,_; ,,ti,, ,,,r,�...�„
_�•a. r:r,i, -,'vl h, , • t 'tf'• .0`�,1 i y•+, _ - ..Lc4:.i:S . "-i;i' _
- 1 -
'Benc6ma�kN
:'in _-,;,.. 3 _ --4-;
,, r.:
t::'1` :,
r:,tn' _
L•{�,, �,tw 51' ,I a. •+ -d51'an'''"-`
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00
• ...,, , . .;.,� <;''
60'4.9.0'. :.
wO �� bo
.i°r':f,.,n�'r,,•r�QQ.r
Do 6
tJ t, F
N If
TF
ote. you report a sampled value in excess of the benchmark value, you must implement Tier 1 or Tier 2 responses. See General Permit text.
Does 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 Monitarino Rt-nuiramPnte
.
.: '.;` Date' . - ; 00556;r C . ,. s;100-530
-�
��
f -
J' -
' le'
p ,Collected,;
',,~,�
Oil ;a#idxredse; is o"a Sud' ended Solids
" 'r' >" ,.,`4 v'N,'ew;iVlotoc•Oil.lJsa
PH'�'a.,
rt.,r ,.
`rico%dd/
; '- .-M:s -, .1.F t
r /F;;, ,, n;,.;: ,.. '.,, r:
'':m
:ri�r' e
"Standard;units �;,4y,_; ,,ti,, ,,,r,�...�„
:'in _-,;,.. 3 _ --4-;
• '- ,A er;a e;;annual', gal/mo
•,`,,=�;;,;���=vm�ffi
Benchiiiark'''';=': ,
_
• ...,, , . .;.,� <;''
60'4.9.0'. :.
TF
-• -- .7 -. Y..=• o va,ua ILI CM Ubb UL LUC oencnmarx value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses.
See General Permit text.
STORM EVENT CHARACTERISTICS:
Date (first event sampled) Mail Original and one copy to:
Total Event Precipitation (inches): Attn: DWQ Central Files
NCDENR/ DWQ
1617 Mail Service Center
Date (list each additional event sampled this reporting period, and rainfall amount) Raleigh, NC 27699-1617
Total Event Precipitation (inches):
S WU-248-102107
Page 1 of 2

STORMWATER DIF 'ARGE OUTFALL (SDO)
MONIT0,t.1NG REPORT
�
"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
information submitted. Based on my inquiry of the person or persons who manage he system, or those personste the
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."
3C) IS
(Signature of Permittee) (Date)
i
S WU-248-102107