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HomeMy WebLinkAboutNCG060185 DMR SW (12)STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT GENERAL PERMIT NO. NCG060000 CERTII+ICATE OF COVERAGE NO. FACILITY NAME —�ic�� FgrrAS L /_ L PERSON COLLECTING SAMPLES jeTe�.•� g,,r�,� CERTIFIED LABORATORY �„« �/ -c. t Lab # 5111r Lab # Part A: Specific Monitoring Requirements SAMPLES COLLECTED DURING CALL NDARYEAR: G • (This monitoring report is due at the Division no later than 30 days from the date the facility receives ti a sampling results from the laboratory.) COUNTY-`� PHONE NO. (3j` g PLEASE SIGN ON THE REVERSE 4 E I Outfall . Date053 _ ; n� ,.'� ,�, ,; .d i' .'':�- 0 ' � "I• '/; „�i i,' Ill ill 1 .L, ,,•1;�'. ��'ii J'��16 , No. ;', ;5'�grhple';i,'•+),,,. i Total, Snstielltl�d'a',i`r I'ic,.,;IG'^;I'1 `';'phi I• ;,GliGmi''al^,Q oil' ?'t�. Oil'.,and, oi5e i,,;i ''.,,. GI e ,I', 'P enl Collfornl tlllected''' lit � ' �, :,I,, �1 ,•,,,r''<I„ ';• +��i ,1.. , ,;i,l ;1 _ � 4 .(,I": 'i: , �,1', me(.�-�`1� i; "'' �'!'''�I�,1 m� �, noidd/- I„ , , '''�I �•.'� .,"q� l` :I, ,,:+nl'9 1'1'•I'i'�. � ..,: '�,. ,, , �, I J. Y 1,� I�i�'I•,II I ,'i; 4 .i �;i�'I, i� ,71. "•,. �-rold)(1'i�s IIGY�Y�b 1:'i' - Iienchniarlt�•• '',. -'' �,•', ,.r, 109'...1 r�•,.1,., ����� h• ;Wttt'iki..6'A'--�'.0 �� :; . ',; ,11120' I �;I, ,i,,, ;,,;01i' ;;; ,• , 000 'KT ,o TF. 1 ,1 ..1. 11 YOU , Ups, � a aau,Y,U Vii U16 III oxcoMS ui 1110 uenGLIMartc vame, or outsiae the oenchmarlc range for pH, you must implement Tier 1 or Tier 2 responses. See General Permit text. Did this facility perform Vehicle Maintenance Aotivides using more than 55 gallons of new motor oil per month? _ yes no (if yes, complete Part B) Part B. Vehicle Maintenance Activity Mnnihnrino Poni,irmmontu Oatfall No. iienchrnark Date' 00556", ' Sample Collected Oil and'GI•ea�e;, r -,I j, - ;;;' r ;�' ""', 30 r' 00530 00,400'.1,,: .Totaluusp'�nded 5olid�, :, ,pi-Y,:'� I,i N+ew 'otor Oil Usage, Ariuicatlivern a al/;IIo _ N i If 1 l 11— you report a samp ed va ue in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tiet 2 responses. See General Permit text. STORM EVENT CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (Inches): Date (list each additional event sampled this repotting period, and rainfall amount) Total Event Precipitation (inches): Mall Original and one copy to: Division of Water Quality Attn: DWQ Central Piles 1617 Mail Service Center Italeigh, North Carolina 27699-1617 MAY 2 0 2016 "ENTRAL FILE$ 010 SFCT10Nj oTT/TT - I - nom. "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 nay 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 pny 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." (Nignature of Fernuttee) (Date S )ArU-249-102107 Page 2 of 2