NCG060185 DMR SW (14)

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
dFNERAL PERMIT NO. NCG060000
CERTIFICATE OF COVERAGE NO. NCG06
FACILITY NAME Q., P!e rafts L C
PERSON COLLECTING SAMPLES -Zcrar►./ 13 owl: -e,
CERTIFIED LABORATORY Q.tc A, -I,#! Lab #.37 7
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 0
(This monitoring report is due at the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
ECEIVEDCOUNTY S Urrl/
PHONE NO. (33(. )3 2r(0 - &,I
FEF3 17 2016
PLEASE SIGN ON 'THE REVERSE 4
C Eiv-1-til_ FILES
QWR SECTION
Outfall Date 00530,,,:,:-
00400No.
0.034b .,
= , •,OQ'SS�s';
;;,, ,;,3'x'6'16
y' ,;Sainple Total' Suspended' ,'ri','
;,,; , H
p' '
Gh mi 6h.O en '
xY
+••
Oi1,,andtiGrease�
,: i„ �'Fecal Coliform,
',,,,
rl'
taridard"units'
„F,
y.'•';I)'einatii�
`' "1;
'; ' �►g'''
"'' 0
Coldiiics per 10 nil
wfi, , ,'•
„I',
;.,. ,
c',
Benchmark' _ ; II 100"".
00'.-,�;•_��„�-
j;,
:,Wtt�izi;6.0•—�'.0'
••�:,' '120' �
�!:�•,, ,�30,:,,,, ,'�
;�' �,�',1000
XT..- Tr_.-..------� --------'-' ----�_ .. ..
GNU«. 11 YUU ,ot,u„ a sau,lT,cu value rn excess or the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses.
See General Permit text.
Did 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 Remvirements
Outfall Date' 00556•=•,;,” ,,•
No: Sample Colle'cte'd; „Oil and - Greas'e;,. _
mo/d'd/' r; • tri' /L,
00530 00,400
;Total 8usp6nded Solids, • - ,pH;'' i New Motor Oil Usage,
Mk/L,, Standhrd;.fihits _ Aiirril'xvera a al/mo
Benchmark „
100
iwMo. 11 yvu ►oYun. a sampieu value In excess or the benchmark value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses.
See General Permit text.
STORM EVENT CHARACTERISTICS:
Date (first event sampled)
Total Event Precipitation (inches):
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Mail Original and one copy to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
cucnT IAn ing1n7

"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 any 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." v:r:
(Signature of Permittee) (Da )
SWU-249-102107
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