HomeMy WebLinkAboutNCS000289 DMR SW (15) STORMWATER DISCHARGE OUTFALL(SDO)
MONITORING REPORT r , p 7: ,s.fk%)if:II pgioilif
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Permit Nu_naborfe- ---' -‘ or SAMPLES COLLECTED DOR T..-1- ..-'1:2-kNal .R.',Y-:•E• !R• -;
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Certificate of Coverage Number: NCG - (This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sampling results front the labora',rv.) ,, •
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FACILITY NA NEE S Lt-rw.A".3-206:1--k LnJ bokyracer tier5 1--_,___•___ _,____ cowry a..L's a. rid4///'
PERSON COLLECTENIG SAMPLE(S) ..)/-ell-- 0,- c.-) -2.,-/-'4,__. • ""- •NE NO ',.. 6 - Li1_6 i
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CER 11FIED LABORATORY(S) 5C- Lab # -376- / • ... ,i - air ."JAW Wir
Lab #
RFCEIVE (Sf-GNATURE OF P ..f E OR DESIGNEE)
By this signature, [certify that this report is accurate
NOV I 2015 complete to the best of my knowledge.
Part A: Specific Monitoring Requirements
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Does this facility perform Vehicle Maintenance Activities using more thrvi 55 gallons of new motor oil per month?_yes .4 no
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitorin: R •[lire:I:cents
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FC::I- S W:,--:46-"260
STORM E 'ENT. CHARACTERISTICS: Mail Original and one copy to•
Division of Water Qitah;y
Date Attn: Central Files
Total Event Precipitation(inches): I6I7 Mail Service Center
Event Duration (hours): (only if applicable— see per:rut ) Raleigh, ^forth C'arohna 27699-i 617
(if more char one storm even: was sampled)
Date -
Total Event Precipitation(inches):
Event Duration (hours): (only if applicable-see per-mit)
"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 subrnitted. 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 my 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 "
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(Signature of Permittee] ( ) �"