NCG060185 DMR SW (17)

STORMWATER DISCHARGE OUTFALL(SDO) •
MONITORING REPORT
GENERAL PERMIT NO.NCG060000 SAMPLES COLLECTED DURING CALENDAR YEAR: i
CERTIFICATE OF COVERAGE NO.NA M t16 ? ,! (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 1"/o.fqe re-rift S j L ( COUNTY Svrr'
PERSON COLLECTING SAMPLES -3ereenq RFCEIVED PHONE NO. ( 36, ) ,354 'Sna,7
CERTIFIED LABORATORY dr,cr4:c Lab #
/loS
Lab# AUG 2 9 2016 PLEASE SIGN ON THE REVERSE -3.
Part A: Specific Monitoring Requirements CENTRAL FILES
WR SECTION
'Outfall , pate — 00534th: ;,,a,,ai,' 00400 :.00340 ,1 I, ,,,;,I; }
Nn. :'•�,,'S'�iivlple• �,;�,•' „h ,Totnrsus elia'•`'di,l';' ° ,�,., , pl, �,;i �'"tr°i� "OQ',S,S�r�ih'�,u„ ',1 •,i,,,,ull;, ,i,'CJ'�'�'16 .
i' �y ;,, a. �'� , ;:'p1T Gh mi 1'O eri ' Oilanil reflse ,ai
' 1 i ' , ;'� : ': , 'S'1�, . �'�,d, �' ¢ 1 y,'; 'FecHl Collfornri
COfleL.tedl,r , adv•„.•' ",I,,,' '•i ,1,. I. r. ,•,�,,p ', f
, ,i,',' ,�oli��pf.•° r;�tAYi'ilaril'tinits •i. ,IyettlaYit� 'I'�'1' •= m�/L� ',�,,"' �'r'�olbiiies''lihr�lll0 ml
., "m /ddl ,h 4 "�' '�''� '�,'`��'.• �1'f�4� ' �' 'i^'`il•'' i'i' r.'" i'I'�' 'P�'',n?,•�� i 'i'16� (, •, ;•I 1
, ''rn /I� .:I;' ''J'I';, i,`} ,� 'I.$1' ', y;•� 4y'(:i ,,�•,,ub�i i� ;ii" ''•
Benchmark' . , - ,. r, `LOb';i;�.,,1 !'.,Vit i'irf, '0' 0' "' , ;it„,
00 1 7- ?o/(p no
� l �': �'. I,, !';1120'„ r' !'' 0,,;,r i II•;' i'1006 '
aJ ��
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 . ` •
No: $axn Ye Collected, � r.. 'O(I,�f00 i. :,,
p O'il and.Creas'e;,. _ Total Suspended Solids II'' .i.'
'Eno/d'd! t- ., .' - '�'' ;,• ..,'; ' � �; P y• Ntirw Motor Oil Usage,
I3enchmarl[ ,_ •y .� Iiti3Q mgIL , „ Standard;iinits , Ani(util'average gall;no
” , 100,:- 'r',.I 1, .6,0_.9A', „ „
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: Mall 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):
O\lrrT nen tnnrn .

"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 intprisonment for knowing violations."
4--____
e 11/6
(Signature of =xnittee) (Dat
S WU-249-102107
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