HomeMy WebLinkAboutNCG200343_MONITORING INFO_20170629STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v
DOC TYPE
❑ HISTORICAL FILE
CY MONITORING REPORTS
a b 1' O
DOC DATE
❑
YYYYM M DD
f \�
STORMWATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG200000
D �ISCHARGE MONITORING REPORT (DMR)
CERTIFICATE OF COVERAGE NO. NCG20 0�
❑ Mad"ongin Iandrofee
FACILITY NAME xvtrifWCfuaO PERSON COLLECTING SAMPLES Ann Centro (Files
CERTIFIED LABORATORY Mc11 e rvC
Lab # Raletah' N6 ut l aaroliaa
COUNTY L jQVAt (fJ..nTy
PHONE NO.
Part A- Cnprifir Mnnitr rino Rpanirpmenfs
i
SAMPLES COLLECTED DURING
CALENDAR YEAR: 011
(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.)
'" ' Outfall
*' Dale* 3,t
z,3 00530r
, ,.,;„ 00340 "a
a 00556 y0
00400
�ry01113
-` ' 01119
`` 00980E.
01114 M
�01094h'?
t' }a Now.'
a
Sampl`ei k
..Total n
5 Rainfall '
'Total,Suspended,
Oxygen
,yOd &Grease
pHrt
Cadrmum
=Copper
xY
Collected
r
= t Sohdsrc r
,Chem kcal
zSDemand -;,
,
s
Q a
":-
r
:. 'r
'
':=:
..`,m%dd/vr ..
_ amches _
,, m
..„- m -
. -t =m
s u.,
= m
,m •
.. m _ - c
.m „_ _
.�.t m
VtV�120 -rs� ,
P4".',01r'?i..t
6'0 , 9.0,
'. 01101Y E"
> 0.007
a:. N/A F, ;'.
- . 0.03 -_�
ts,0'06Vr,
0 -
/,
Y70
2so
07.20
79
6 14c6
Aae
7o.6
a.3J
• 7e
oI.S11
6 0
31.0
1Q. 10
=i
o-
5"
o
O
DOD63e
O
-
t.5,..
If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier I or Tier 2 responses in the GeneralPermit.
2 Total recoverable.
Only complete Part B if this facility uses more than 55 gallons of new motor oil per month.
Part B: Vehicle Maintenance Activity Mo itoring Re mrements
5,Quitfall
P -Date;, t
`, Tolalb°
ew'Mo o� Oil'
00530"�'M
00400
r'00556,V70
r a.N
,n mple
'M'+Collected�t,.�
g Rainfall
Usage Y
�,°x".Sohdsx'z"vis
uTotal Suspended
z�rpH Y
�,rr^ w
Otl &Grease r
' ""`
a— '1�+�
.#moldd/
ra4
ches?
aVinonth
RECEIVED
JUN 2 9 ?r f
CENTRAL FILES
DWR SECTION
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"1 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 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."
(Signa re of Permdtee) (Date)
NCG200000 D, R Form SWU-256
Page 1 of I