NCG060042 DMR SW (2)

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG060000
CERTIFICATE OF COVERAGE NO. NCG06. 0Oq;�_
FACILITY NAME (_0M*1&%tJ4cWk rcolS
PERSON COLLECTING SAMPLES Nee. e
CERTIFIED LABORATORY ah Lab # M
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: ;4 15
(This monitoring report is due at the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
RECEF� gg' c
ENO. 63��?.00
NOV 2 4 2PLEASE SIGN ON THE REVERSE 4
CENTRAL FILES
DWR SECTION
�Outfail _
-
-_Date`
Sample:-
-Collected
Trio%dd/`r;m
.00530'?"
=`00400; €_;00340w
0,0556; 31616
,Total,Suspended-::--`
Solid's _ -�
2':>
�=� ' ' _ �pH;._ _' �'
4:=
�'Standaid uiiifsDeinand'
-� _.�;:
��Chemical Oxygen-,,
in 0/L,
- Oitand-Grease;, Fecal Coliform,_
���iii' _ 'Colonies per 100;1
- -
1000
0
0
b
4yAIA
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 Z uC o
(if yes, complete Part B)
Part B: Vehicle Maintenance Activitv Monitoring Reauirements
-�
No.
Date'-
Sam ' le Coll
p ected,,
mo/dd/ r,
- 00556`
andGxeas
'rn
-00400
ended Solids H New Motor Oil Usage
- `m ��' 'Staridard�iinI S - Annaal averse aUmo
100
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:
Date fihn_ 1!5 (first event sampled)
Total Event Precipitation (inches): �•LS
Date k) -U- (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches): 1.1 v
Mail Original and one copy to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
S WU-249-102107
Pagel of 2

"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."
of Permittee)
If -
(Date)
S WU-249-102107
Page 2 of 2

L
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG060000
CERTIFICATE OF COVERAGE NO. NCG06 B O
FACILITY NAME Ca rhvv0✓ 0CJ41k &4 h S
PERSON COLLECTING SAMPLES tkr-k e
CERTIFIED LABORATORY" Lab # 3EF
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 901
(This monitoring report is due at the Division no later than 30 days from
the date the facility receives thfg sa�np ' g results from the laboratory.)
COUNTY X0,
_ri sw+
PHONE NO. ( 336 )„(4(4 'f20
PLEASE SIGN ON THE REVERSE 4
Outfall-'
''No.
,Date
Sample
,Collected,
00530
- 00400'
00340'
_ = 00556-<-
31616
Total -Suspended_
Solids,
. = _ =pH; ,'
Standard units -.
Cheinicai Oxygen,.
Demand;
.- Oil;and Grease,
mg%L -
Fecal Coliform;
Colonies per 100 -ml
;Benchmark -
-
100.
"Within 6.0 — 9.0,:
- 120 _
30
1000.,
in I
p
7, 3
1<LIA
Mj-
ioaD 1 4
0-S
&')
<5
NA
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 j,/no
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
,; Outfall
No:
"Date-
Sample Collected,,',,
r
-'00556 "00530.,, ='00400- "
Oil and Grease , : " _ Total Suspended_ Solids, -pH,:.' ' , New Motor Oil Usage,
m ' ,Annual average al/momo/dd/
;Benclimark'
-
30 100. .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.
See General Permit text.
STORM EVENT CHARACTERISTICS:
Date 10)41 S(first event sampled) It
Total Event Precipitation (inches): L a -S
Date 1041- (list each additional event sampled this reporting period, and rainfall amount)
r
Total Event Precipitation (inches): 1-)4
Mail Original and one copy to:
Division of Water Quality -
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
SWU-249-102107
Pagel of 2

LI \---- j
"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."
k AJ -4,
of Permittee)
(Date)
SWU-249-102107
Page 2 of 2