NCG090023 DMR SW

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG090000
CERTIFICATE OF COVERAGE NO. NCG090023
FACILITY NAME Engneered Polymer SOIIIS. DBA ValSpar
PERSON COLLECTING SAMPLE(S) Rqrl:V Sparks
CERTIFIED LABORATORY(S) StateSVll a Analytical Lab # 440
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 2015
(This monitoring report shall be received by the Division no later than 30 days
from the date the facility receives the sampling results from the laboratory.)
COUNTY Iredell
PHONE NO. (704 ) 761-2321
Outfall
No.
Date
Sample
Collected
50050
01027 01034
01051
Total
Flow
Total Total
Cadmium Chromium
Total
Lead
Oil and
Grease
mo/dd/ r
MG
ug/l ug/I
ug/I
1
07/14/15
"
<.001 MCI <.002m
.004 m
al/mo
"
<.001 Mg .005 mg
Ong mq
(SIGNATURE OF PERMITTEE OR DESIGNEE)
By this signature, I certify that this report is accurate
complete to the best of my knowledge
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes Xno
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
Oil and
Grease
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/dd/ r
MG
m /l
m /l
unit
al/mo
STORM EVENT CHARACTERISTICS:
Date 07/14/15
Total Event Precipitation (inches): _72"
Event Duration (hours): 1
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours):
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Form SWU-255-072502
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STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING 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 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) (Date)
Form SWU-255-072502
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