NCG080295 DMR SW

GENERAL PERMIT NO. NCGO80000
CERTIFICATE OF COVERAGE NO. NCG08 6 2 9
STORIMWATER DISCHARGE OUTFALL (SDO)
MOMTORING REPORT
Dece-4- -ey-
SAMPLES COLLECTED DURING CALENDAR YEAR: ;O/Z/
(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.)
FACILITY NAME rt -e f 1, _ k� COUNTY L eno r r
PERSON COLLECTING SAMPLES '0-o e . rd PHONE NO. Sz) S2 2 - o -5-9 3
CERTIFIED LABORATORY_ -7:i -P v- c Lab #
Lab # PLEASE SIGN ON THE REVERSE 4
Part A: Vehicle Maintenance Areas Monitoring Requirements
Did this lacility perform Vehicle Maintenance Activities _no
using more than 55 gallons of new motor oil her month'? s
(if yes. report your analytical results in the table immediately below)
Outfall
No.,
Date
Sample Collected,
mo/dd/yr
00530'
Total Su•spended.Solids;
mg/L
00400
pH,
Standard units-
00556
Oil'and Grease, New Motor Oil Usage,
mg/L Annual average gal/mo-
Benchmark
-
100
Within' 6.0,-,9.0
30 -
u
iV d
Note: If you ieport a sampled value in excess of the benchnruk value. or outside the benchmark range for pH, you must ririplement Tier 1 or Tier 2 responses
See General Permit teat.
Part B: Oillwater Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals
Outfall Date 00556.
No. Sample Collected, Oil and Grease,
mo/dd/yr . m /L
00530'
;" Total Suspended Solids,
mg/L
00400
pH,-
Standard units
Permit Limit - 30
'•100.
6.0-9.0
STORM EVENT CHARACTERISTICS:
Date/�/Z4�/� (first event sampled)
Total Event Precipitation (inches): 6
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
Attir DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
SWU-250-103107
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"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. used 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 firs t 4 imprisonment for knowing violations."
(Signature of
Z�
( ate)
S W U-350-102107
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