NCG060012 DMR SW

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG060000 SAMPLES COLLECTED DURING CALENDAR YEAR: O/c'
CERTIFICATE OF COVERAGE NO. NCG06_0Q12 (This monitoring report is due at the Division no later than 30 days from
FACILITY NAME 5 LLC, the date the facility receTYs the sampling results from the laboratory.)
PERSON COLLECTING SAMPLES S Pel R E C EN
CERTIFIED LABORATORY Lab # SEPr, Q VA 40 2 4 NE No. (g�
1ti Ih Lab # � '�' "LASE SIGN ON THE REVERSE 4
Part A: Specific Monitoring Requirements CENTRAL FILES
DWR SECTION
Outfall
•" •Date' -
,, .. . ,
.'- �,_ 00530;:.;
00400
"'
"00340 G,
,., ,°� :;•'
Outfall. -'Date _,? ..•.' =,i,;.r
No:
',,,,,,.,�, �'�' i���,, �,� .�';�� =316.16. ,
4 :,00556•,
No.
ample'
d;..'
::,Tot al'.Suspended:,t;";''
''
'�; M,•„ y; ;;;''pII,.
Fr 1
Chemical', Oxygen,';
li0il,and Grease'
, �; Fecal Coliform .
F.,
,Cone"te
c r
mo%d
,;�,:.
,Solids :..; ,.
, ',
'.':: .; ,
,_� +'Sfanda
r' rd_units'
,. 9' ' J:I
„� •, .;�•,,
�." ,Demand
%
:. �.;,.. ,-',Colo'
:',6
J —,}',: mg/L%',\; inies
•.
_
° ,
ai' YI�I;;
I Iil : a;S ii i•��,�rJ"
per,100' Illi
tle''...i I'. 4 _
'
Benchmark
Within; 6.'0 - 9.0- _
• ' ' 120
4
co1-6-93-115-
a,s
, -1000
L S Nb
14
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.
See General Permit text.
Did 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 Activi
onitoring Requirements
Outfall. -'Date _,? ..•.' =,i,;.r
No:
` '; = _ 00556 r ,, , ,, , ...,,.
00530"
Sample'Coll''&ted," _ Oil;'and'Greas'e''
= mo/d'd%' -,a . :,,. :,, .. �:, M,. s¢ ;Tota
;;
t Sus Solids
p'ended , •
:i', PH�k': ; i
-NeN_Motor, Oil Usage,
ro.,
Benchmark
r�'m /L a_" ,y'
r.•
m
Stand ard'.units•
Annual Avera a al/mo
_
,.
5 .�"-;J30a' .•�;';.
'- a
.1009.4
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.
See General Permit text.
STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Date 5t ly (first event sampled) Division of Water Quality
Total Event Precipitation (inches):�,— Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
SWU-249-102107
P.— 1 _F'/

"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)
S WU-249-102107
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