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NCG060185 DMR SW (16)
STORMWATER DISCHARGE OUTFALL(SDO) MONITORING REPORT GENERAL PERMIT NO.NCG060000 SAMPLES COLLECTED DURING CALENDAR YEAR: C CERTIFICATE OF COVERAGE NO. CG06:._ _`-',k,;, --S•---L_--a (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 CIL/A r�rs,S L L C_ COUNTY r RECEIVED PERSON COLLECTING SAMP�ES j e;� ,w._/ �©�<1� .A► PHONE NO.(336-,f)sem: s CERTIFIED LABORATORY c,,6I' i4 Lab # ? ' '�fly Lab# y JUN 2 9 2015 PLEASE SIGN ON THE REVERSE - Part A: Specific Monitoring Requirements CENTRAL FILES DWR SECTION .Outfall . ' " Date 0053 a,, ; „ " ' • �' Q ,,:,:�� • •: 011400 ��0034Q �';� OQ'�5�'` - No. � �S:iimple� '' ,.r,,. �. .., ,.. : ;� ; ;;�,� '_ ;,. �' '�; ,,•, ���r �•' Total'Suspended'a i`r'ri ,'I',r, pH, Glignnei l,Oxygen , • - `� -�pIlEcted' -�� '`�'-'- '`�' '•' � �'- '• _ • and.Greases�L,, 'Fecal Coliform,• • Solids, •,° ^„ n, s, �' m mann r _ ,•, , ; ',_ ;;�rStd'dar`,d'"units � ,ISe �� : �' � ��' - 0 aril in(AiU `', , ,,,-• ;: y, .,•: r, _ ', ,i, ' `!,,';.; ' ig/L", Y,Coldnies per 1 tl Yr • ,�,.,L �'dng/L �. _:•! �•ri'P�. •�;• �.�•, ,•,,m��j�;;'��,•�,,,a�;,;�;;;, •,,: ;,�,; ;i ;a,;, - ��,, � �„ Benchmark' „ •,a.. 100'^ ,:�•..;, ,,.„ , ,',Wtt m'.6':'0- p • :i; ''':•;;'43(1.1.1.11„ , ,• '' � li �� 20'. r•,r; ,;���30..:,,p.. i +�"� , ,!141:.2, 77 Note:If you report a sampled value in excess of 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 Requirements Outfall Date' • 00556 +;, , • 00530 • -• , . ' 00,400'i.• No: ' Sample Collected, .,Oil and,Grease;,. :Total Suspended Solids ' pH;'; New Motor Oil Usage, •mo/d'd/yr i•.. • trig/I,:' ,,. , mg%L._ . . , - Standard`;iunits ., . - • ;���• �Annual'average gal/mo Benchmark •- ;, „30','i 100 , ,a. �, 6,0—.90,;^'' - Note: If you report a sampled value in excess of 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: Mail Original and one copy to: Division of Water Quality Date (first event sampled) Attn:DWQ Central Files Total Event Precipitation(inches): 1617 Mail Service Center Raleigh,North Carolina 27699-1617 Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation(inches): C\x ITT-inn tnv1r-r "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." - C72321.4L.Q.71 „al," c2 /5 (Signature of Permittee) at / S WU-249-102107 Page 2 of 2