NCG060189 DMR SW

STORIVIWATER DISCHARGE OUTFALL (SDO)
- MONITORING REPORT
GENERAL PERMIT NO. NCG060000
CERTIFICATE OF COVERAGE NO. NCG06_ ©1 n
FACILITY NAME ( (` � N G Calf -,Q
PERSON COLLECTING SAMPLES L
CERTIFIED LABORATORY Lab
n. S i►-. Lab " ,
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DU72ING CALENDAR YEAR: 401 �. ,
(This monitoring report is due at the Division no later than 30 days from
the date the facility receivesth s m li results from the laboratory.)
COUNTY i 7 !\ (A_
PHONE NO. MU) f - ay p()
PLEASE SIGN ON THE REVERSE ->
Outfall Date
ct
00530
00400
1 00340
00556 31616
No. Sample
Total Suspended
pH,
Chemical Oxygen
Oil and Grease, Fecal Coliform,
Collected,
Solids,
Standard units
Demand,
mg/L Colonies per 100 ml
mo/dd/yr
mR
mJL
Benchmark -
100
Within 6.0 - 9.0
120
30 1000
D l 1,Q
Cc
10
t
Note: If you report a sampled value
in e.c fh b
p ss o e enchmxk value, or outside the benchmark range for pH, you must implement Tier I or Tier 2 responses.
See General Permit text.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? — yes _no RECEIVED
(if yes, complete Part B) " JAN 2-0 2015
Part B: Vehicle Maintenance Activity Mnnirnr;na
Outfall
No.
Benchmark
- - .--------- --_ .......,...,
Date 00556
Sample Collected, Oil and Grease,
mo/dd/ m
- 30
00530
Total Suspended Solids,
mg
100
00400
pH,
Standard units
6.0-9.0
UENTR�
DWR S
New Motor Oil Usage,
Annual average val/mo
_
Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement
See General Permit text Tier 1 or Tier 2 responses.
STORM EVENT CHARACTERISTICS: .
Date ///(1f'trst event sampled)
Total Event Precipitation (inches): 0•
Date (list each additional event sampled this, reporting period, and rainfall amount)
Total Event Precipitation (inches):
Mail Original and one copy to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
kL FILES
CTION
SWU-249-102107
Page 1 of -7

_ "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." .
n
(Signature of Permittee)
(Date)
S WU-249-102107
Pat,e 2 of 2