NCS000336 DMR SW

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
SAMPLES COLLECTED DURING CALENDAR YEAR: 2015
Permit Number NCS --0-0--03-3-6—
(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 UFP Elizabeth City, LLC COUNTY Pasauotank
PERSON COLLECTING SAMPLE(S) Adam Fritz PHONE NO. )3 3 8 - 2 8 2
CERTIED LABORATORY(S)yri en n Newbnf Lab #
CEIVE®
IFx
Lab #(SIGNATURE OF PERMITTEE OR DESIGNEE)
� DEC U 4 Z01 J By this signature, I certify that this report is accurate
complete to the best of my knowledge.
U--& A . e. —4riir Mnnitnrina Renuirements
CENTRAL FILES
MtAlr] Off^TV1A1
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes x no
(if yes, complete Part B)
Part B: Vehicle
Maintenance Ac
ivity Monitoring
Requirements
00530
00400
Outfall
No.
Date
Sample
50050
Total Flow
Total
00556
Oil & Grease
Non -polar
Total
pH
New Motor
e Oil Usage
g
Collected
(if applicable)
Rainfall
(if appl.)
O&G/TPH
Suspended
(Method 1664
Solids
SGT -HEM), if
a 1.
unit
al/mo
mo/dd/ r
MG
inches
Form SWU-247-062310
Page l of 2

STORM EVENT CHARACTERISTICS:
Date NA
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) (only if applicable —see permit.)
Event Duration (hours): { Y pP
This DMR is for the period from -May'l through October 31, 2015
Mail original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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 bel' true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibili f of roes and i risonment for knowing violations."
/J
(Date)
Form SWU-247-062310
Page 2 of 2