NCS000244 DMR SW (5)

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS V0 -110 -02 -44 -r7 --'-
FACILITY NAME M
PERSON COLLECTING SAMPLE(S)
CERTIFIED LABORATORY(S) Er�v 4
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: Z -O 1 ,c--
(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 ' r \ '15 W 1' CA<
PHONE NO. 5I d > -;� 1 - 6 q 9 3
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2. 11
Outfall Date
50050
50050
No. Sample
Collected
Total Totalt
Flow if a Rainfall ©p T5 S
C7 t k -b vi y i
G t> `-'r K N �� a- ca 1 c o in e
mo/dd/ r
MG inches 7 1-M
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 /l
mg/1
unit
al/mo
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes _►io
(if yes, complete Part B)
Part B: Vehicle Maintenance Activitv Monitoring Reauirements N 1\
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 /l
mg/1
unit
al/mo
Form S WU-247, lost revised 2/2/2012
Page l of 2

(G(2 /\ 4-) h ve-� \
J
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS 0( Q Z- 14 44
FACILITY NAME
PERSON COLLECTING SAMPLE(S) L�h�
CERTIFIED LABORATORY(S) t:.nv . Cin x n- :s Lab # W 0 9
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 20 IS
(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 iR" �'i V'+ ; C- L4
PHONE NO. ilk Oj 7K --9- ( - D ac ci
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Outfall Date
50050
50050
00556
No. Sample
Collected
Total
Flow if a
Total
Rainfall
Azk. arl0 L {-�c„��,
i�o�ro P -f I
1c oM%V
mo/dd/ r
MG
inches
M. / V
(>`1—
,tl
t I/g iS
mo/dd/ r
0. IS"
< i0 I< Ick
410
m /I
unit
al/mo
Does 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 Activity Monitoring Reauirements ! V
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 /l
m /I
unit
al/mo
Form SWU-247, last revised 212/2012
Page l of 2

STORM EVENTCHARACTERISTICS: NMI Original and one copy to:
— -- -- ——-------------------Division-of-Water C,)uality---- -- — --
Date_ Attn: Cential Files
"Total Event Precipitation (inches): 1617 Mail Service Centel-
Event
enterEvent Duration (hours): Z , O'?, 3 (only if applicable— see permit.) Raleigh, North Carolina 27699-1617
(if more than one Stam event was sampled)
Date
"Total Event Precipitation (inches):.___
Event Duration (honrs): — (only if applicable— see permit.)
"I ccrtify, under penalty of Iaw, that this document oind 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. 1 am aware tha( there are significant penalties for suhmitting false information,
including the possibility of lines and imprisonment for knowing viola(ious."
Signature of Pernlit(ec) (Date)
Fonn SWU-247, last revised 2/21201.2
Page 2 of 2