NCS000294 DMR SW (5)

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS 000294 SAMPLES COLLECTED DURING CALENDAR YEAR: 2015
(This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
FACILITY NAME Southern States Cooperative-Creedmoor
PERSON COLLECTING SAMPLE(S) Andrew Rodak
CERTIFIED LABORATORY(S) Environmental Science Corporation Lab # EW375
Lab #
Part A: Specific Monitoring Requirements
COUNTY Granville
PHONE NO. (_919_) 528-1516
SIGNATURE OF PERMITTEE OR DESIGNEE
REOUIRED ON PAGE 2.
Outfall
No.
Date
Sample
Collected
mg/L
m
mg/L
mg/L
mg/L
mg/L
Rainfall
Duration
pH, Standard
Units
Sulfate,
9056
BOD,
SM5210B
COD,
410.4
Ammonia
Nitrogen,
350.1
Nitrate-
Nitrite,
9056
Total
Phosphorus,
365.1
Benchmark
mo/dd/yr
Minutes
(6.0-9.0)
250
30
1 120
7.2
10
2
Outfall 3 East
05/31/15
NO DISCHARGE
Outfall 1 west
05/31/15
NO DISCHARGE
DIE
.-
Outfall
No.
Date
Sample
Collected
mg/L
mg/L mg/L
NITiMINU
Rainfall pH, Standard Kjeldahl Suspended Total Nitrogen
Duration Units Nitrogen, Solids,
TKN, 351.2 2540D
Benchmark
mo/dd/ r
Minutes
6.0-9.0
20 1100
1 30
Outfall 3 East
05/31/15
NO DISCHARGE
Outfall 1 west
05/31/15
NO DISCHARGE
Form SWU-247, last revised 2/2/2012
Page 1 of 2

Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? X no
(if yes, complete Part B)
Part B: Vehicle Maintenance Acti ity MonitoringRe uirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total
Rainfall
Oil & Grease
(if appl.)
Non -polar
O&G/TPH
(Method 1664
SGT -HEM), if
appl.
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/dd/ r
MG
inches
m
m
unit
at/mo
STORM EVENT CHARACTERISTICS:
Date
Total Event Precipitation (inches):
Event Duration (hours): _ (only if applicable — see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
Mail Original and one copy to:
Division of Energy, Mineral, and Land Resources
Attn: Central Files
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
"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."
EZ JK,4� l0-11-15
(Signa re "Perittee) (Date)
Form SWU-247, last revised 2/2/2012
Page 2 of 2