NCG100084_MONITORING INFO_19990408

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT N0.
/V
DOC TYPE
El HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ 1 �1 �1 �i n `1 d �
YYYYMMDD

STORMWATER DISCHARGE MONITORING REPORT (DMR)
Please Mail Original And One Copy To Mailing Address On Back Of This porml
GENERAL PERMIT NO. NCG 100000
Part A: Facility Inforniation
Samples Collected In Calendar Year: l CA 1� I (all samples shall be reported following receipt from lab, but no later than January 31 of the following year)
Certificate Of Coverage No. NCG10 p0C FS' ' County of Facility
Facility Name w ' 1 f '--Sj1U -1-,01 Name of Laboratory
Facility Contact �_ { _ Lab Certification # T)(, _FAO A115
Facility Contact Phone No. { _) �3 � ��9 _ t& L" P%? mac(
Part B: Specific Monitoring Requirements
ter.- � UM � � - I � DS45� � g1688
Uutfall I " I}ate 5Q{150 00400�,t� 005Stit 01051� , 0.,
,3.r'� rl �"i�f rr ./°"r-^_v'. °', ! R.. c=s7 }savK. }:' +�€ xiur :.res 4�fi*'
Sample . _ Total t pH �9 Oil and ryra . y No. x Lead; Totalq Totals Eth en
max A�1 3g' rr
Collected, , Flo'Ai -''"s r Grease a Recoverable Suspended) Glycol
iaFtv.'i.1
�� �'�' ^;:� �^�,�7r� / � 7���/^+'_ �€`�t�'.•. f�'�# .-'r��.�t� � � ���►nt `r SQ.,II/tdSi_l7if
L4.�sy1a}ff3w� raoldd/y>r MG llnita"" r+�t mT i `fir sLs''S' �Sra 1 1_ mg/l � L RARM
o too <V--sio
Does the facility perform vehicle washing and fueling? _ yes X no
Part C: Storm Event Clio racte ristics
Total Event Precipitation (inches): l
Event Duration (hours):
(if more than one storm event was sampled)
Total Event Precipitation (inches):
Event Duration (hours):
Part D:
p1� 2� 0 W N
APO - 8 1999
WASHINGTON REGIONAL OFFICE
DWO
"Based upon my inquiry of the person or persons directly responsible for managing
compliance with the permit monitoring requirement for total toxic organics (TTO),
I certify that, to the best of my knowledge and belief, no dumping of concentrated
toxic organics into the stormwater or areas which are exposed to rainfall or stormwater
runoff has occurred since filing the last discharge monitoring report. I further certify
that this facility is implementing the solvent management plan included in the Stormwater
Pollution Prevention Plan."
(Signature of Permit
Ll
(Date)
Form DMR10 Page I

"I certify, under penalty of law, that this document and all attachments were prepared under my direction of
supervision in accordance with a system designed to assures 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 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."
(Sigd'atu a of Permittee) / (Da(e)
MAILING ADDRESS:
Attn: Central Files
DEIINR
N.C. Division of Water Quality
P.O. Box 29535
Raleigh, NC 27626-0535
Form DMR 10 page 7