NCG080769 DMR SW

STORMWATER DISCHARGE OUTFALL(SDO)
MONITORING REPORT
GENERAL PERMIT NO.NCG080000 SAMPLES COLLECTED DURING CALENDAR YEAR: i G
CERTIFICATE OF COVERAGE NO, Ce0 ,, ., (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 5 c, N w spy Gkr+-rt.:Tr le"S. COUNTY E02y ph
PERSON COLLECTING SAMPLES ( J Gel iN7 e-r-"fie PHONE NO.( 331.) P i 7 1 5 l/
CERTIFIED LABORATORY Re-se a-v-4 , •-4,„1_ y r cal Lab# 3 77 til
Lab# PLEASE SIGN ON THE REVERSE--> RECEIVED
Part A:Vehicle Maintenance Areas Monitoring Requirements
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?yes _no SEP 0 ( Z U t 0
(if yes,report your analytical results in the table immediately below)
CENTRAL FILES
DWR SECTION
Outfall Date 00530 00400 00556 _ _
No. Sample Collected, Total Suspended Solids, pH, Oil and Grease, New Motor Oil Usage,
mo/dd/yr mg/L Standard units mg/L Annual average gal/mo
Benchmark - 100 Within 6.0—9.0 30 -
/ S/21/1.0 ,/,P,-6 7 . .:, s '$T7},
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.
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals
Outfall Date 00556 00530 00400 _
No. Sample Collected, Oil and Grease, Total Suspended Solids, pH,
mo/dd/yr mg/1L mg/L Standard units
Permit Limit - 30 100 6.0—9.0
,
STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Division of Water Quality
Date g/A/It- (first event sampled) Attn:DWQ Central Files
Total Event Precipitation(inches): r 0 5 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):
SWU-250-102107
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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 personnell 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 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."
/S--"1/4-- . -----2—. i 3//6
(Sig t e of Permittee (Dat f
SWU-250-102107
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