NCG060323_MONITORING INFO_20190711

vv), '(D)D
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑ HISTORICAL FILE
fY MONITORING REPORTS
DOC DATE
❑ 00
YYYYMMDD

Or'.
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL. PERMIT NO. NCG060000 Z SAMPLES COLLECTED DURING CALENDAR YEAR:
CERTIFICATE OF COVERAGE NO. NCG06 © Z RF(This.monit^ring report is due at the Division no later than 30 days from
theldate tne.tacility receives the sampling results from the laboratory.)
FACILITY NAME Dao C. :/I% � '"'-'COUNTY 4LIPL.'_1
PERSON COLLECTING SAMPLES JUL-
CERTIFIED LABORATORY ��� �� ab # t y /G 1 12019 PHONE NO. (R� <-) �< - a •% / /
—Lab # CCNTRAL F!LES PLEASE SIGN ON THE
G1htrZ v�CTION REVERSE 4
Part A: Specific Monitoring Requirements
Outfall; :;,
Date
00530
00400
200340, ,;:!:
t„ ..i00556 ,
.531616''t
No.
Sample
Total Suspended 4 ,1
pH,
Chenucul Ocygen 5
011 slid Grease,
w Fecal Coliform
Collected, a
Sohdsq "
r:
�`-Standa�d�units "'
i Demand,' -
" ug/L a ;�
Colonies'per100:m1 =:
;mo/dd/Vr...
,• r
r:;t �. •:,
^,'in
b.
.
,�i60.0.
: 30
1000Benchmark
r7
G26.gc
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 Pan B)
rart rs: venicie ivramtenance Activity
WIRIM-Mg ne mrements
-
:-.Outfall:
'.,:_Date ._c_'�;'.
00556:?. a ..'t....:',.00530
--;,-'
- ,:
00400ii
s --
. 'No
Sample_Collected, >.:i
Oil and Grease,
. Total Suspended Solids,
_
pIi,*_ .::
�;Nevv NIo[or Oil Usage;;:,
,..
' '`..lm 2;.:rAnnual`avera
a aVmo>
Benchmark _
'::
._
.30 -'.
100
6.0:-•9.0
Note: If you report a sampled value in excess
See General Permit text.
STORM EVENT CHARACTERISTICS:
Date ('r9r first event sampled) f 7
Total Event-P ecipitation (inches): .J
value, or outside the benchmark range for pH, you must implement Tier 1 or Tier 2 responses.
Mail Original and one copy to:
Division of Water Quality
Attn: DWQ Central Files
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):
CWI i-9d0_1 m 107

Environmental Chemists, Inc.
4
w',
910.392.0223Lab • 910.392.44^4Fax
710 ltnwsr:rtown Knad, M,1ntc,. NC 27954 252-473.5702 Lab; Fax
2iS-A tNilmingtun (-li},hwsy, Jad<sonville, n'C?E1540 ^ 910347 58,13 Labffax
ANALYTICAL & CONSULTING CHEMISTS infoii;an',•ironmmrtaluhcmists.eenn
Duplin Winery
Date of Report:
Jun 21, 2019
P.O. Box 756
Customer PO #:
Rose HI ill NC 26456
Customer ID:
09060046
Attention: Rob Cottle
Report #:
2019-09475
Project ID: Stormwater
Lab ID Sample ID:
Collect DaterTime Matrix
Sampled by
19-24245 Site: OF-7
6/10/2019 4:30 PM Water
Russell Barwick
Test Method
Residue Suspended (TSS) SM 2540 D
Lab ID Sample ID:
19-24246 Site: OF-7
Test Method
Oil & Grease (0&G)
Lab ID Sample ID:
19-24247 Site: OF-7
Test
EPA 1664
Results
3.9 mg/L
Collect DatelTime Matrix
6/10/2019 4:30 PM Water
Results
Collect Date/Time Matrix
6/10/2019 4:30 PM Water
Date Analyze(
06/13/2019
Sampled by
Russell Barwick
Date Analyzed
<5 mg/L 06/19/2019
Method Results
COD SM 5220D
Comment: �t
Reviewed by: �11GLU`� Q, ( a t0'4'
<20
Sampled by
Russell Barwick
Date Analyzed
1/1- 06/14/2019
Report #.: 2019-0%475 .— , -, 1
\1

�"'ar ENVIRONMENTAL CHEMISTS, INC OFFICE: ill92-0Wilm223 ington,
N2-0424
` NCDENR: OWO CERTIFICATION p 94 NCDHHS: DLS CERTIFICATION If 37729
Analytical d Consulting Chemists
COLLECTION AND CHAIN OF CUSTODY
CLIENT: Duplin Winery
PROJECT NAME: Storm water
REPORT NO: / !
/t
ADDRESS: 3 V Z {,
CONTACT NAME:
PO NO:
ffl,,l
> 5 L , / vy C j g
REPORT TO:
PHONE/FAX:
COPY TO:
email:
Sampled Bv: SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, St. = Sludge, Other:
Sample Identification
p
Collection
T
o
£
m
2
'++ a
$ o
c r7
> _
t=
° `o
5 2
`o w
m
9 m
m
PRESERVATION
ANALYSIS REOLIESTED
Date
Time
Temp
w
u
X
i7i
a
z
a
c
4
w
z
�2�
X
X
/TSS, it and Grease, COD
G
r ,v
�O`
2�
X
X
G
Z--
TS Oil and Grease COD
/E'G
G
/
t
P
1�
X
/
�(
`�-
TSS, Oil and Greas COD
y
/Y
G
G
P
X
X
TSS, Oil and Grease, COD
G
G
C
P
X
X
TSS, Oil and Grease, COD
G
G
C
P
X
I X
TSS, Oil and Grease, COD
G
G
C
P
X
X
TSS, Oil and Grease, COD
G
G
C
P
G
G
C
P
G
G
C
P
G
G
NOTICE - DECHLORINATION: Samples for Am nia, KN. Cyanide, Phenol and Bacteria must be oechlormateci (0.2 ppm or less) in the field at the time of collection. See reverse for instructions
Transfer
Rel'nqui ed By:
Date/rime
Received By:
Date/rime
y
{{
2.
f ��
Temperature wh If ge6eived: Accepted:___,,Z__ _ Rejected: Resample Requested:
Delivered By: ` —_ -___ —`Received By: i�` 7 �' L it Date: Time: r?

0
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
G
Permit No.: NIC 1,al4l0/ 0/ 0/ D/ or Certificate of Coverage No.: N/C/G/O/ 6 /a / 7/ 2 /,Q /
Facility Name: 5 p 0 i rl /�• � � �
County: iD t9 Li � .. Phone No. r0 ' j j /
Inspectori�Sc /l Flr.✓'� l�
Date of Inspection:
By this si ertify that this report iscurate and complete to the best of my knowledge:
of Pennittee or
1. Outfall Description
Outfall No. / Structure (pipe, ditch, etc. ell
Receiving Stream: �%£ b .� V rA,y (- i-1 .
Describe the industrial activities that occur within the outfall drainage area
2. Color
Describe the color of the discharge using basic colors (red, b l
dark) as descriptors: % t
3. Odor
etc.) and tint (light, medium,
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.) /)i OAJZ-
4. Clarity
Choose the number which best describes the clarity of the discharge where I is clear and 10 is very
cloudy:
2 3 4 5 6 7 8 9 10
i
Page 1
SWU-242.020705

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge inhere
I is no solids and 10 is the surface coveted with floating solids:
6 2 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 ' nno solids and 10 is extremely muddy:
e 1 J 2 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes o
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes No
9. Reposition at Outfall
Is there deposition of material (sediment, etc.) at or immediately below the outfall? Yes DNo
10. Erosion at Outfall
Is there erosion at or immediately below the outfall? Yes No `
11. Other Obvious Indicators of Stormwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion may be
indicative of conditions that warrant further investigation and corrective action.
Page 2
SWU-242-020705

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
G
Permit No.: NICI41,al 4 0/ O/ O/ a/ or Certificate of Coverage No.: N/C/G/ 0/ 6 /4 / t/ —1/ 1 /
Facility Name: !) ?C' J /!I -rJ'
County: / Phone No.
Inspector• _,6 , ,f 5 e- 1 i 6 t (" -j [t is
Date of Inspection: (e,) - / V- 2 v i 9
By this signanli�l certify that this r5port is accurate and complete to the best of my knowledge
(Signature o?Pennittee or Designee)
1. Outfall Description
Outfall No. Structure (pipe, ditch, etc.) / c c
Receiving Stream: 4- 4, t it ✓ A5,n .,)c
Describe the industrial activities that occur within the outfall drainage area:
2. Color
Describe the color of the discharge us tn basic colors (red, brr wn, blue etc.) and tint (light, medium,
dark) as descriptors: 2(! ��/ r- T /1�
3. Odor
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.)
/rrn�
a. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
1 3 4 5 6 7 g 9 10
Page 1
SWU-242-020705

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
1( 2 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
1 0 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes NNo
8. OR Sheen
Is there an oil sheen in the stormwater discharge? Yes No
9. Deposition at Outfall
Is there deposition of material (sediment, etc.) at or immediately below the outfall? Yes No
10. Erosion at Outfall
Is there erosion at or immediately below the outfall? Yes rNjo
11. Other Obvious Indicators of Stormwater Pollution
List and describe
�l ( E,,
Note: Low clarity, high solids, and/or the presence of foam, oil sheer, deposition or erosion may be
indicative of conditions that warrant further investigation and corrective action.
Page 2
SWU-242-020705

l
J
Y
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Permit No.: NICIIQIy/O/ q 0/ a/ or Certificate of Coverage No.: N/C/G/ O/6 /a / Y/ 2 l /
Facility Name: / l a Pi ` / %! `rj P 1/
County: 6 P c Phone No. 7)
Inspector: d• S'S� (/ �7r41 ✓ a/< -
Date of Inspection:
By this si$nature�I2rrtify that this re rt is ai�Furate and complete to the best of my knowledge:
or Designee)
1. Outfall Description
Outfall No. . ' Structure (pipe, ditch, etc.) ✓' ��
Receiving Stream: Gs/1 y • ✓ fAry K
Describe the industrial activities that occur within the outfall drainage
2. Color
Describe the color of the
dark) as descriptors:
3. Odor
/n r-
5�. b
basic colors (red, brown, blue, etc.) and tint (light, medium,
2
Describe any distinct ollors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.) iL Mood "�'
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
1 C 3 4 5 6 7 8 9 10
Page I
SWU-242-020705

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and
�10 is the surface covered with floating solids:
1 I/ 2 J 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
1 10 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes No
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes . No
9. Deposition at Outfall
Is there deposition of material (sediment, etc.) at or immediately below the outfall?
10. Erosion at Outfall
Is there erosion at or immediately below the outfall? Yes No
11. Other Obvious Indicators of Stormwater Pollution
List and describe
Yes 60)
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion may be
indicative of conditions that warrant further investigation and corrective action.
Page 2
SWU-242-020705

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
G
Permit No.: N/C41,al / D/ D/ O/ D/ or Certificate of Coverage No.: N/C/G/ .O�/ & / Z/ 2
Facility Name: " ' ✓ kj i✓ "��
County: Phone No.
Inspector: /'iaSs'rit 1"5d/?u'e-/.-
Date of Inspection: f' /'0 - 2 C. ( '7
By this signatuEr,-I certify that thi5,rpport is
or
and complete to the best of my knowledge:
1. Outfall Description
Outfall No. Structure (pipe, ditch, etc.) / i ;/ e S 4zE
Receiving Stream: 4�n /' ` l �4'-o H
Describe the industrial activities that occur within the outfall drainage area:
2. Color
Describe the color of the
dark) as descriptors:
3. Odor
Describe any distinct
etc.)
4. Clarity
using basj cold (red, brown, blue, etc.) and tint (light, medium,
that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
3 4 5 6 7
Page 1
8 9 10
SWU-242-020705

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
1 CD 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where I is no solids and 10 is extremely muddy:
t 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes 'No
S. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes Vo
9. Deposition at Outfall
Is there deposition of material (sediment, etc.) at or immediately below the outfalP Yes ONO
10. Erosion at Outfall
Is there erosion at or immediately below the outfall? Yes (N)o
11. Other Obvious Indicators of Stormwater Pollution
List and describe i J"( l,yC�` I"
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion may be
indicative of conditions that warrant further investigation and corrective action.
Page 2
SWU-242.020705

a
;�
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
6
Permit No.: NIG4/,a/ 4 6/ O/
Facility Name:
h•/�pG'�
County: 1 12L" ✓
Inspector: _41
Date of Inspection:
By this signs , certify that this
or Certificate of Coverage No.: N/C/G/ 0/6/D / 7/? l L/
s ,C
Phone No. /6 - Z. %� c'" /
is accurl and complete to the best of my knowledge:
(Signature of Petmittee or Designee)
1. Outfall Description ` i� /
Outfall No. �Csnucture (pipe, ditch, etc.) i"� f `7 r^ �' � ` D r r N
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area
2. Color
Describe the color of the discharge using basic olors (red, brown, blue, etc.) and tint (light, medium,
dark) as descriptors: / � �",/�i ��-��' i� /
3. Odor
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.) �h
4. Clarity
Choose the number which best describes the clarity of the discharge where I is clear and 10 is very
cloudy: /��
1 ( 31 3 4 5 6 7 8 9 10
Page 1
SWU-242-020705

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
I ; 20 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
I 0 3 4 5 6 7 8 9 t0
7. Foam
Is there any foam in the stormwater discharge? Yes ao
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes No
9. Deposition at Oatfall
Is there deposition of material (sediment, etc.) at or immediately below the outfall? Yes No
10. Erosion at Outfall
Is there erosion at or immediately below the otufall? Yes No
11. Other Obvious Indicators of St rmwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam oil sheen, deposition or erosion may be
indicative of conditions that warrant further investigation and corrective action.
Page 2
SWU-242-020705

G
Permit No.: N/C/A
Facility Name:
County: / P
Inspector: u
Date of Inspection:
By this s
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
O/ D/ or Certificate of Coverage No.: N/C/G/ 0/ 6 /a / P/ 2 / 4 /
Z- f "r
Phone No.����
certify that thereport is a9purate and complete to the best of my knowledge:
r(Signiture of Permittee or Designee)
1. Outfall Description a
Outfall No. —42— Structure (pipe, ditch, etcJ
Receiving Stream: a'J/5 ✓ /S/A✓
Describe the industrial activities that occur within the outfall drainage area:
2. Color
Describe the color of the
dark) as descriptors:
3. Odor
Describe any
etc.)
using bascolors (red, brown, blue, etc.) and tint (light, medium,
that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
.4. Clarity .
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
1 2 > 3 4 5 6 7 8 9 10
'i
Page 1
SWU-242-020705

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
I is no solids and 10 is the surface covered with floating solids: '
I t2 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
1 f 2\ 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes No
8. OR Sheen
Is there an oil sheen in the stormwater discharge? Yes No
9. Deposition at Outfall
Is there deposition of material (sediment, etc.) at or immediately below the outfall? Yes No
10. Erosion at Outfall
Is there erosion at or immediately below the outfall? Yes No
11. Other Obvious Indicators of Stormwater Pollution
List and describe ( G t
Note: Low clarity, high solids, and/or the Presence of foam, oil sheen, deposition or erosion may be
indicative of conditions that warrant further investigation and corrective action.
Page 2
SWU-242-020705

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Permit No.: N/C/ /Q/!s/o/.
Facility Name:
County: L� uPn c :.✓
Inspector:
Date of Inspection:
By this si I certify that
-(Stgnatule of Permittee or Designee)
1. Outfall Description
or Certificate of Coverage No.: N/GG/ o! 6 /a / T! 2 / 3 /
Phone No.
accurate and complete to the best of my knowledge:
Outfall No. Structure (pi ,ditch, etc.)elf>o
Receiving Stream: N L
Describe the industrial activities that occur [thin the outfall drainage area:
2. Color
Describe the color of the
dark) as descriptors:
3. Odor
Describe any distinct
etc.) J
basic
etc.) and tint (light, medium,
that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
1 2 3 4 5 6 7 8 9 10
Page 1
SWU-242-020705

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
1 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
1 � 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes No
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes No
9. Deposition at Outfall
Is there deposition of material (sedimen4 etc.) at or immediately below the outfall? Ye No
10. Erosion at Outfall
Is there erosion at or immediately below the outfall? Yes 60
11. Other Obvious Indigators of Stormwater Pollution
List and describe tC
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion may be
indicative of conditions that warrant further investigation and corrective action.
Page 2
SWU-242.020705

A r�+A
A
t
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
G
Permit No.: N/C/ij/Q/ 4 / O/ a/o/ D/ or Certificate of Coverage No.: N/CQ 0/ 6 /Q/ 3/ 2
Facility Name:
County: /•) c nJ Phone No.
Inspector: euSS-Cll
Date of Inspection:By this poa re, I certify that tea'
1
accurate and complete to the best of my knowledge:
-(Slgnatufe of Permittee or Designee)
1. Outfal] Description n J
Outfall No. —5— Shucture (pi , ditch, etc.)
Receiving Stream: �..
Describe the industrial activities that occur within the outfall drainage area:
2. Color
Describe the color of the
dark) as descriptors:
3. Odor
Describe any distinct
etc.)
basic
etc.) and tint (light, medium,
G
that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
1 3 4 S 6 7 S 9 10
Page 1
SWU-242-020705

S. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
1 Ij 1/ 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
1 � 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes /No
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes No
9. Deposition at Outfall
is there deposition of material (sediment, etc.) at or immediately below the outfall? Ye No
10. Erosion at Outfall
Is there erosion at or immediately below the outfall? Yes 60
11. Other Obvious Indicators of Stormwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion may be
indicative of conditions that warrant further investigation and corrective action.
Page 2
SWU-242-020705

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
G
Permit No.: N/C/ j,/Q/ 4l O/ o/ O/ D/ or Certificate of Coverage No.: N/C/G/ o/6/Q/ 7/ 2 11/
Facility Name:
County: 4xiO!' ✓ Phone No. le —
Inspector: �� CS t "'1 j i l�
Date of Inspection:
By this §igna' turd Ycertify thasthis repoyt is accurate and complete to the best of my knowledge:
(Stignaturdof Petmittee o—r Designee)
1. Outfall Description
Outfall No. Structure (Wipe, ditch, etc.) e, er
Receiving Stream: /
Describe the industrial activities that occur within the outfall drainage
2. Color /
Describe the color of the dischargeJ}Ming basic colo�s (red,
dark) as descriptors: / . L ZAO--C
etc.) and tint (light, medium,
3. Odor
Describe any distinct odd that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.)
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
1 0 3 4 5 6 7 8 9 10
Page 1
' SWU-242-020705

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
l is no solids and 110 is the surface covered with floating solids:
3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where I is no nds and 10 is extremely muddy:
1 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes No
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes l No
9. Deposition at Outfall
Is there deposition of material (sediment, etc.) at or immediately below the outfall?
10. Erosion at Outfall
Is there erosion at or immediately below the outfall? Yes No
11. Other Obvious Indicators of Soormwater Pollution
List and describe
Yes 'No
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion may be
indicative of conditions that warrant further investigation and corrective action.
Page 2
SWU-242-020705

a
-i
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Permit No.: NlCIA[/,a/4 O/ D/ O/ D/ or Certificate of Coverage No.: N/C/O/ o/ Q /a /!/ A
Facility
County:
Inspect(
Date of
By this si e, ertify that this{epomis aycurate and complete to the best of my knowledge:
(Si gnatf re of Pemuttee or Designee)
J
1. Outfall Description
Outfall No. Structure (pipe, ditch, etc.)
Receiving Stream: l A 5 t/ �/4 ✓ /
Describe the industrial activities that occur within the outfall drainage area:
2. Color
Describe the color of the
dark) as descriptors:
3. Odor
Describe any distinct odors
etc.) 4)
basic cogs (red, brown blue, etc.) and tint (light, medium,
t the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
/ o
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy: ��
1 �� 2/ 3 4 5 6 7 8 9 10
Page 1
SWU-242-020705 '

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
I(02 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where I is no/soolliddss and 10 is extremely muddy:
1 / 2
7. Foam�/ 3 4 5 6 7 8 9 10
Is there any foam in the stormwater discharge? Yes 610
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes (N
9. Deposition at Outfall
Is there deposition of material (sediment, etc.) at or immediately below the outfall? Yes oNo
10. Erosion at Outfall
Is there erosion at or immediately below the outfall? Yes No
11. Other Obvious Indt'eators of Stormwater Pollution
List and describe (`f�
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion may be
indicative of conditions that warrant further investigation and corrective action.
Page 2
SWU-242-020705

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
G
Pemvt No.: N1CI4/1aJ4I0/
Facility Name: o L
County: 4�q �'
Inspector: �u
Date of Inspection:
By this jgff e,
I certify that this r;port is accyrate and complete to the best of my knowledge:
(Signatur f Pernrittee or Designee)
1. Outfall Description
Outfall No. — -- Structure (pipe, ditch, etc.) 0 br / �' "f P £/
5
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color
Describe the color of the
dark) as descriptors:
3. Odor
Describe any distinct
etc.)
using ba c colors (rfd, brown, blue, etc.) and tint (light, medium,
. , i
that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
1 / 2/ 3 4 5 6 7 8 9 10
Page 1
SWU-242-020705

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
1 C2) 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
1 'v 3 4 5 6 7 8 9 10
7. Foam \\/
Is there any foam in the stormwater discharge? Yes N� o
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes ' No
9. Deposition at Outfall
Is there deposition of material (sediment, etc.) at or immediately below the outfall? Yes o No
10. Erosion at Outfall
Is there erosion at or immediately below the otafall? Yes No
11. Other Obvious Indicators of Stommwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion may be
indicative of conditions that warrant further investigation and corrective action.
Page 2
SWU-242-020705

2
Permit No.: N
Facility Name:
County: E'
Inspector:
Date of Inspec
By this si nail
r
r•
Stormwater Discharge Outfall (00)
Qualitative Monitoring Report
a/ or Certificate of Coverage No.:
S r" -/
Phone No. C!/z'',!J(9�- V-3 (
that thiu4rt is acc/rate and complete to the best of my knowledge:
,,
(Siva e of f tmittee or Designee)
1. Outfall Description
Outfall No S[ructure (i ditch etc)
"Gp ,� (Jf �t �
pe,
Receiving Stream: 6I / t
Describe the industrial activities that occur within a outfall drainage
2. Color
Describe the color of the
dark) as descriptors: _
3. Odor
Describe any
etc.)
basic lors ed, brown• blue, etc.) and tint (light, medium,
that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
1 l LZ/ 3 4 5 6 7 8 9 10
Page 1
SWU-242-020705

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface coveted with floating solids:
I 0 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
1 12/ 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes 00
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes No
9. Deposition at Outfall
Is there deposition of material (sediment, etc.) at or immediately below the outfall?
10. Erosion at Outfall
Is there erosion at or immediately below the outfall? Yes 00
11. Other Obvious Indicators of Stormwater Pollution
List and describe
f,£4N
Yes 0
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion may be
indicative of conditions that warrant further investigation and corrective action.
Page 2
swu-242-020705

G
Permit No.: N/G#/Q/
Facility Namy:
County:
Inspector: i< s
Date of Inspection:
By this sigr ture ee
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
fy that this rgpdrt is acouratg and complete to the best of my knowledge:
(,signature of remuttee or uesignee/
1. Outfall Description
Outfall No. Slructu;e (pig, ditch, etc)
Receiving Stream: �/ ;J �� ✓�
Describe the industrial activities that occur within the outfall drainage ai
2. Color
Describe the color of the
dark) as descriptors: _
3. Odor
Describe any
etc.)
basic colors (red, brown, blue, etc.) and tint (light, medium,
lLi7 �
that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy: �j�
I /(3 / 4 5 6 7 8 9 10
i
Page 1
CM9&0W'—WW1

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
1 2 ` 44 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
1 2 � 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes � No/
8. OR Sheen
Is there an oil sheen in the stormwater discharge? Yes No
9. Deposition at Outfall
Is there deposition of material (sediment, etc.) at or immediately below the outfall? Yes F
10. Erosion at Outfall
Is there erosion at or immediately below the outfall? Yes nNo
11. Other Obvious Indicators of Stormwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion may be
indicative of conditions that warrant further investigation and corrective action.
Page 2
SWU-2427020705