NCG060185 DMR SW (7)

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG060000 SAMPLES COLLECTED DURING CALENDAR YEAR:
CERTIFICATE OF COVERAGE NO. NCC06 0 (This monitoring report is due at the Division no later than 30 days from
f
FACILITY NAME 61% - receives the sampling results from the laboratory.)
Ar,,+s BUNTY 4�r
PERSON COLLECTING SAMPLES er' c`I ori s' 3 0 2015 PHONE NO. C3)R� SSfG 7
CERTIFIED LABORATORY bre Q n a l .� Lab# 9'13
Lab # CENTRAL FRES LEASE SIGN ON THE REVERSE 4
Part A: Specific Monitoring Requirements SWR SECTION
. ' Outfall .
OCat_
Date
�; ;-"
00530 �.'
0
;� . 0'04 0
�, •,,0.0340:AQ'$�1,L�,,r.
No.
'' ,, Sample ,
1,, :Total, Sus end d' �,�,,'
p 4;
�i;;a =• u' . H
.6, ;;p ,
;ChGmi�al'•OxMe
:rs,'Oil.,and�,Oreasea • s „li;,•'Fecal Coliform,
NntP• Tfvn11 r nrr a ..l e.! ...L. _,...,. _r.L-
Cbllected',rra ' ;
„SolId� ; °
_.
; 1 .$tana8i d anus'
.� '
; I)einaiitl
mg °'. ,,, ',Colooies''per 1Q0 Tril
mo/8d/ r I
,'
"? ?i:';
is ,{, i :
,..
;,,,; ,
!'�a;
;
Benchmark'
-
100'.,
i .',..
0
- o):,,,
O
,1000
Nnta• Ti l)nn t•Gnnri
o c um..1uA ..n i..e
: _ _L _ _ _1____ _
1 1
_ __
-- J_ ., r.,. .. �w...r.,
.0 rwiuu n
U acCuaa i uic bunumnaik 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 Activitv Mnnitnrino Ranuiramante
Outfall Date'
No: Sample Collected,
Benchmark _ i,_..
00556
Oil and6Greasei,
wr4�'' r30:�
00530
Total Suspended S01ids,
/I:
100`- .a' i;
ri , `00,406'1..%
i•.
pH;, i New,Motor Oil Usage,
Stagdard'•,units Anuual'avera a al/mo
;,=• di0.-•9'0',4 _•
NntP• Tfvn11 r nrr a ..l e.! ...L. _,...,. _r.L-
See General Permit text.
STORM EVENT CHARACTERISTICS:
Date (first event sampled)
Total Event Precipitation (inches):
Mr, uoiiuiunartc wdue, or outside Ine bencninark range for pH, you must implement Tier 1 or Tier 2 responses.
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
ctxnT Inn iMtn-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 any 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)
(Dat
SAV -249-102107
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