HomeMy WebLinkAboutNCS000030 DMR SWSTORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NCS 150bO6,7d or
Certificate of Coverage Number: NCG
FACILITY NAME APC/ J E ! 0J I14L r -E
PERSON COLLECTING SAMPLES) _LC-Pl �S
CERTIFIED LABORATORY(S) A An/,¢L jnL'eL, Lab #
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: ?'D
(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 Glu a b H P,"
PHONE NO. (s3 C.
(SONATURE OF PERMITTEE OR DESIGNEE)
By this signature, I certify that this report is accurate
complete to the best of my lmowledge.
_
rTotal
p
i
00556
00430
00400
Total Flow
(if applicable)
Total Rainfall
Oil & Grease
(if SPA)
Non -polar
O&GfUH
(Method 1664
SGT -HEM), C
appl.
Total
S
Solids
New otor Oil
Usage
malddl r
MG
inches
1024
Units
o
,D
D
3.1
U
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? )L. yes no
(if yes, complete Part B)
Part B: Vehicle Maintenanre Activity Manitnrina RPnntrPmanta
Outfall
No.
Date
Sample
Collected
50050
00556
00430
00400
Total Flow
(if applicable)
Total Rainfall
Oil & Grease
(if SPA)
Non -polar
O&GfUH
(Method 1664
SGT -HEM), C
appl.
Total
S
Solids
New otor Oil
Usage
malddl r
MG
inches
1024
Units
o
,D
D
3.1
U
Form SWU-246-062310
Page I of 2
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Certificate of Coverage No. NCG
FACILITY NAME R6119 -rill (t 1=
PERSON COLLECTING SAMPLE(S) c kef-'- -C
CERTIFIED LABORATORY(S) P4e-e-- Lab #
Lab #
SAMPLES COLLECTED DURING CALENDAR YEAR: zo I q
(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
PHONF,NO.(33(-
(SIGNATURIK OF PERMITTEE OR DESIGNEE)
By this signature, I certify that this report Is accurate
complete to the best of my knowledge.
Part A: Vehicle Maintenance Activity Monitoring Requirements (only U, on average, more than 55 gallons per month of new motor oil is used)
Outfall Date
No. Sample Collect4
mo/dd/yr
00556
Total Rainfall, New Motor Oil Usage, Oft and Grease,
inches Annnal average mg/L
Rammo
Non -polar O&Cw7M
(Method 1664 SGT-EIEW
da
00530
Total Suspended Solids,
ma
004M
Standard units
Benchmark -
- 30
15
100
6.0-9.0
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses in the General Permit.
Mall Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"I certify, under penalty of la,that this document and all attachments were prepared under my direction or supervision In accordance with a system designed to
assure that qualified personnelk roperly 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 awahat there are signifi nt penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of
(Signature o P ttee) (Date)
Form SWU-254-062310
Page 1 of I
STORM EVENT CHARACTERISTICS:
Date ,t 11S 11q
Total Event Precipitation (inches): 0, Z1
Event Duration (hours): 7 (only if applicable — see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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 qualified personnel property gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the s em, or those persons directly responsible for gathering the information, the Information submitted is, to the best
of my knowledge and beUef, e, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including thVpossibility of fin d imprisonment for knowing violations."
1z 0
(Date)
Foran SWU-246-062310
Page 2 of 2