NCG060009_MONITORING INFO_19990608

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V U& O Io t�O
HOC TYPE
El HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ I � 7 1 Ul0 D ZS
YYYYMMDD

STORMWATER DISCHARGE MONITORING REPORT (DMR)
Please Mail Original And One Copy To Mailing Address On Back Of This Form
GENERAL PERMIT NO. NCG060000
Part A: Facility Information
Samples Collected In Calendar Year: 1 � q (all samples shall he reported following receipt from lab, but no later Ilia January 31 of the following year)
Certificate Of Coverage No. NCG06 0000 County of Facility Ro60.5,N,,
Facility Name Koc-C.o FC'rW-\ i~oods Name of Laboratory PN'-�— i C'�'
Facility Contact 1.h r-A . 3 l So�-- Lai) Certification #
Facility Contact Phone No. ( 9)Ojr;
Part R Specrflc Monitoring Requirements
Outfall
Noy
'
1natev,
S�inpte
rCotlected
50050M
�Totat�� �:pli}
Fltirq
0400
h "�
. 0055&
r011 and
Grease,"
€00545��
Total ; ;
Suspenclea
Oo340
iCitemlcai
OxY6enGohform1
3161G w
eca
Fl
k
<.
molddt r::
MG'
unit 3:
m
m
t:100 m!.
q
53
c,o.
TT
-i o..?1
31tv
Footnote I Fecal Coliform sampling applicable only to facilities processing meats.
RECEIVED
JUN 0 8 1999
FAYETTEViLLE
REG. OFr;Gc
Does the facility perform vehicle washing and fueling?— yes /no
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes Zo
(if yes, complete Part Q
Part G: Vehicle Maintenance Activity Monttorun e Requirements
Form DMR06

Part D: Storm Event Characteristics
Total Invent Precipitation (inches): 1
Event Duration (hours):_
(if more than one storm event was sampled)
Total Event Precipitation (inches):
Event Duration (hours):
"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 riny idgg iry 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.imprison'ment for knowing viola!jqns." ti !
(Sign`atur of P
MAILING ADDRESS:
ttee)
Attn: Central Files
DEHNR
N. C. Division of Water Quality
P.O. Box 29535
Raleigh, NC 27626-0535
Form DMR06

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG060000 SAMPLES COLLECTED DURING CALENDAR YEAR: La-Imc
CERTIFICATE OF COVERAGE NO. NCG06 060 9 (all samples collected during a calendar year, shall he reported no later than January 31 of
the following year)
FACILITY NAME R3CCb COUNTY u&Fso ry
PERSON COLLECTING AMPLE() t,t,. PHONE.
CERTIFIED LABORATORY(S) thY Q.Q I,�iE t c_ 1N c_- Lab#Ts
37
Lab # (SIGNATURE F PER ITTEE R DE I NEE)
By this signature, I certify that this report is accurate and
complete to the best of my knowledge
Part A: Specific Monitoring Requirements
.......-...... ..:�M..W �.
a 0 0 1 >o00
ad :. .�.st.,3.,p,: ±;a kiY,§: se i -t.. ,'�7F'[- i.:>iv- S�fl.F�:-. 3_• . _,. ,::, - 4 ys,_, j,., .. y.� 'i h.e�. .' } .' k•A I-t tj: r
,� • -s. P v.. ; L- }%4 d..t r i.•' �:� �a7f. �. �.s`�w`C'i
Y..:i,. i t'.a. •,• •i •S+�`. - � ,Y
Does this faciliiy perform Vehicle Mauuenanee'Activlties using more than 55 gallons of riew- motor oil
(if yes `coinplete,Part1B) y ,• -,- vi r f f ,.,. , fP .r
, ,3'`' ti+.-"�`�� tiYrgi-• 01 °�'r t�? i� v.c��t::• 7+'.: ,i4 '"�'��,�i �7- 2 i:,re+1 �T,..:� ��,� ti�,�r •a.,�4?�.;- ,�
Part B: Vehicle Maintenance Activit .Monitorin -Re uirements 4aa�l� p St105@ ,> tla�s6 �tDSi - 3g26o W4WL
No Sxrnnie T4tai Ull s�td Imo, Tntat Iletergents pH
:; �a)lez#td Eo�r Gt�ea,ae: 12ecoreraWc� CM>3A�S)� �atot• � - - - � a�i
:..':.777to 'fl._f ..:;; :.unit
,Ci .iit. R. i�A�":; :'r'1 ° tr};a:�'i:a=.-.%�3�i '-F� - _ .• _ e. .� _ . 4
MAW
TAYETTE VRiEF�Ir�
STORM EVENT CHARACTERISTICS-' _. _.
_ Mail Original and one copy to:
Total Event Precipitation (inches): 1' �� - Attn: Central Files
Event Duration (hours):' �. • r+iZ Division of Environmental Mgt.
DEHNR
(if snore than one storm event was -sampled) n �; > •, -:r P.O. Box 29535
Total Event Precipitation (inches): t,5 Raleigh, NC 27626-0535
. Event Duration (hours): It • N R
Form M R06 �^/

1 Fecal Coliform and Ammonia Nitrogen sampling applicable only to facilities processing meats.
2 Detergent sampling applicable only to facilities manufacturing soaps, detergents, or cleaning preparations.
3 Cyanide sampling applicable only to facilities manufacturing drugs. For facilities not using or storing cyanide, the facility may make certification
to the effect that cyanide is not used or stared at the facility and thus obtain a waiver of the cyanide sampling requirement.
By this signature, I certify that cyanide is not being used or stored at this facility
(Signature)
4 Chlorides sampling applicable only to facilities processing vegetables or meats.
4
_
rye\ - ...
5 Applies:only for facilities at which fueling occurs. _ , • .
6 Detergent monitoring is required only'at facilities ,which -conduct vehicle cleaning operations.
6
_ f • �`E. r`7 i 4l•' �.F rz{'tµ :�• lfo.l°['1' V .---r.,� J �•r�
ii
adz "I certify,_under penalty of law, that this document and all attachments were prepared under m ` direction or :: • =
:�.,
su envision in accordance wttti a s stem desi ried to assu"re th"at� ualified' ersonnei' rb erl ,"tither and evaluate the
P Y g q P P P yt5
_
f t..
_-information, information, submitted.. Basedon_ my_inquiry,of_the person'or persons who manage the system, or those'versons
r dirictly,resp6nsible forgatherin'g the.information the information submitted is, to the best of m knowled a and belief
`. true, accurate; and complete: _ am aware that these are'significant'penalties for.submitting false information, including'
.
the possibility of fines and imprisonment for knowing violations,"j.=
•�.�.�
.,: ~,F
., i'.� 4- o,•: ye. •�...�a:-rsw.r -n .K ty...w +.}.n4 rw y.. .i�i. - i ��- t.i >!� i �1 -
«,1 ,YR i
of Permtttee) (Dat_e)-T-,�+. ,^ t' Y
��-' - -ter �� rr �•±}'`+' `` .. t" �W � < ,� �vr._...•r1:z-f.. � . J- ___ - - �y.--�-, _ • .c.,.
eI
.. --._ �� -
;..
Form NIR06