NCS000520 DMR SW (12)

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NCS 000520 or
Certificate of Coverage Number: NCG
FACILITY NAME PCS Phosphate Bulk Handling Facility -Morehead City
PERSON COLLECTING SAMPLE(S) Jason Broadwell
CERTIFIED LABORATORY(S) Environment 1 Lab # 10
Lab #
Part A: Specific Monitoring Requirements
21
200
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.)
COUNTY Carteret
PHONE NO. ( 252) 322 - 8283
(SIGNATUR OF PERMITTEE OR DESIGNEE)
By this sign ture, I certify that this report is accurate and
complete to the best of my knowledge.
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 Activity Monitoring Requirements
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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 Activity Monitoring Requirements
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STORM EVENT CHARACTERISTICS:
Mail Original and one copy to:
Date: 1210712015 Division of Water Quality
Total Event Precipitation (inches): 1.17' at sample time Surface Water Protection Section
Event Duration (hours): (only if applicable - see permit.) Attn: Central Files
1617 Mail Service Center
(if more than one storm event was sampled) Raleigh, North Carolina 27699-1617
Date:
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable - see permit.)
"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."
( Dat