NCG080773 DMR SW (5)

STORMWATER DISui,- -.GE OUTFALL (SDO)
MONITORING REPORT
11.
GENERAL PERMIT NO. NCG08000 ,
CERTIFICATE OF COVERAGE NO IVCG08
FACILITY NAME,
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY l-11-1-irl
Lab #
Lab #
SAMPLES COLLECTED DURING CALENDAR YEAR:
(This monitoring report is due at the Division no later than 30 days from
the date the facility receives f ie piing esults from the laboratory.)
' L COUNTY_
PHONE NO. `� /_r% 4//
PLEASE SIGN ON THE REVERSE —>
Part A: Vehicle Maintenance Areas M,nitoring Requirements
Did this facility perform Vehicle Mainte 'nce Activities using more than 55 gallons of new motor oil per month? _yes no
(if yes, report your analytical results in th ' table immediately below) —
EIV
AUG 13 Z01"7
CENTRAL FILES
DWR SECTION
• i e4
Note: If you report a sampled value in ex ';ss of the benchmark value or outside the
benchmark range for pH, you must implement Tier 1 or Tier 2 responses.;
See General Permit text.
Part B: Oil/water Se iarators and Seco a ar Containment Areas at Petroleum Bulk Stations
y^ r„'2titj,1;,;_4gt i „cGSd!a l,.'. ', ayllt and Terminals
�baiel'; r•+ �,..,5 v,,,; u,fiir, a, I;I ,_� ,t lav ;+R'•u r
,el'r �,t� 'Ids;, ,.r, •{r,! •.,l"_'1.:yr.00JSO,Iu�r
',i ,�r '•) {?,i, �7' v Ir''. m17, � _ J., .II',f, r,_ ,V,� �; „t-r?'tr,.� Ir �`l, .11�' !�,,, �,ral'i,li. r ",5i -
''+ +� _
'li .,'tl* .1}i lir lr, I •9r qn'P, r— tl� Say I,dr� �.(LL•�ari'dl area§c' n''Ir�Xl 'Ir, .i,„ nr 'i;d; i^ 9t,•�,,, 7:.i.
,� F. :I d�-k i', { •i': ,irs I'rr,bl-�i' ,� ,511r,t"r, _ n$,rq t kr 'L'lid tlI
S,a'1 � '�13 of ;t 'n t'a „ :,,(`.I+ r�i 1� .I '`d,: . �r N d t . t' ;, • w• , � ! 6 �, r r!, t,�tl S ietSt'1e�db I 'i', .a ! ''tr;y ` �, , • hh
,�I,r i!tiu- I r , u 1 rr��i 4t „Myn• ;tL'! .,I', -!r 'Itj i u, S,olfd$ t+ Pp'�• t„ 1 i ill' �'n 1-� ,Id'yl�ir Irl i,' d,{'atj a' L�
•'.i. ��� . r ,.i r, i'i it ,y6' �f���� ` I, ,r, ',�' ,I !, ,I'1, �il'''li�ii„ ,:� I'i^`�.. 'n' "'i:61n;p^n',,I r,L..p.,
.i I„ 1 r; ;, ,t,?'ul{'�LL,,��d! l�, ,i":��5'f�.• iJ��Pn,elPv IdQ tir ,qi'" r�'' �. p, ,Ii! ;u itq. ,lr ,'Nli.�l 'hii��'IjP,l'ggf i:, iw,�d I,,11l i,Yl,,, ''P•I M1u�rl''Y, ;�� '4, ,I,..{,,I 1 1a
— Y L, , 6 • � I d i" , u,+r!��"i'lr iiii' t i .f � F: �'.d' i ,I."try ,I, � ' ;�I J7 � I'".I ird„�,S'r,u, II 'IJ�Z;Y �'�I� I' � �Ij I I!; {y r P,I'r' '; � I, ! ,r P, , P�a,� I• , ��+,
T:� a.: �'', ;fp t• „r V ,f' • 1 I I'�1� I'' �i°, hv, 11 ist 3 ;i�i�r} ��; r I ^I -I o o .i � • t16",ft', , !
Per , l' ;`;, lo,r ''J" In i'I't' g,Y+ ,l vl,f !-, '4,.,
rmtL1I11Lt;� ii ,IOr,..jl,,.�',{h�(,II�r1'n.'! I,r'I�e` ,4!h��,�1 �I ,�'��'�,a.,"r�'
�r..n• 'U „a L' T1i,p I„tnal c�tP'H'°tiff,
�y,r'!,i;l,'n�l, ;Irk,awh�lx,�r.a'•t,.;..Ij��,b,ffe;il44'q�` r hrl'rNt'Y; Rnct. „
_ i •r
A 7.Oil'�
STORM EVENT CHARACTERISTIC:
Mail Original and one copy to:
Date (first event sam led) Division of Water Quality
Total vent Precipitation (inch s): Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Date (list each additio al event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inch s):
SWU-250-102107
Page 1 of 2

"I certify, under penalty of law, that this document and all attachments were prepared under my,
supervision in accordance with a system designed to assure that qualified personnel properly gath
information submitted. Based on my inquiry-of the,person or persons who-manage the system, or
directly-responsible for gathering the information, the information submitted is, to the best of my
true, accurate, and complete. I am aware that -there are significant penalties for submitting false i
the possibility ine� and imprisonment for knowing violations."
(Signature of Permittee)
(Dad)
'ecnon or
and evaluate the
ase persons
owledge and belief,
irmation, including
SWU-250-102107
Nee 2 of 2