NCG080794 DMR SW (3)

STORMWATER DISCHARGE MONITORING REPORT (DMR)
Please Mail Original And One Copy To Mailing Address On Back Of This Form
GENERAL PERMIT NO. NCG080000
Part A: Facility Information
NOV 10 2015
pwR SECTION
Samples Collected in Calendar Year: 2015 all samples shall be reported following receipt from lab, but no later than January 31 of the following year)
Certificate of Coverage No. NCG08 0794 County of Facility NASH
Facility Name YRC Inc. (Wilson 650) Name of Laboratories
Facility Contact CLINT CARTER Lab Certification Ws
Facility Contact Phone No. [phone]
Part B: Vehicle Maintenance Activitv Monitoring, Reauirementc
Outfall
No.
Date
Sample
Collected
50050
00400
00545
00556
pH
Total
Flow
pH
Total Suspended
Solids
Oil and Grease
New Motor Oil
Usa e
m /l
mm/dd/ r
MG
units
m l
mg/1
al/month
001
Jan — Jun 2015
No samples this period — new motor oil usage is less than 55 gallons
+/-25
002
Represented by SDO-001
Part C: Oil Water Separators and Secondary Containment Arenv at A trnlovm Rvllr Rtntinn and Torminnlc
Outfall Date
No. Sample
Collected
50050
00400
00545
00556
Total
Flow
pH
Total Suspended
Solids
Oil and Grease
mm/dd/ r
MG
units
m /l
Mg/1
Form SWU-250-071400
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STORMWATER DISCHARGE MONITORING REPORT (DMR)
Part D: Storm Event Characteristics
Total Event Precipitation (inches):
Event Duration (hours):
(if more than one storm event was sampled)
Total Event Precipitation (inches):
Event Duration (hours):
"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 violati 7."
(Signature of Permittee (Date)
MAILING ADDRESS:
Attn: Central Files
NCDENR / DWQ
1617 Mail Service Center
Raleigh, NC 27699-1617
Form SWU-250-071400
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