HomeMy WebLinkAboutNCS000289_MONITORING INFO_20191223TLiZ D
STORMWATER DIVISION CODING SHEET
NCS PERMITS
PERMIT NO.
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DOC TYPE
0 FINAL PERMIT
MONITORING REPORTS
O APPLICATION
❑ COMPLIANCE
❑ OTHER
DOC DATE
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Permit Nu ber_ NCS .� `� r
Cev— f caLe of Coverage NLLmber_ :N'CG
STORAIWA"i E'R DLCHARGE OL71TAI.L ;SDO;
MOtiYTORING REPORT
S.-NTPL.ES COLLEC T ED DL`Ri'`G CALEND.A R YEAFc: _
(This moaitoriag report shall tie received by the Div -is as ne later than 30 days from
the date'the facIit-v receives the sampling restdts froth the tabora:cry.)
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FACILIT ,NAIKE S ir, mac. COL�fTY cJL, ;-a.
PERSOti COLLECTLtiG SA.MTLE(S o RtL ��G 1 ONE '�O. f
CERTIFIEDLABOPATORY(S) Fc V Labi? 7��
Labtt � C '� ZQ�g (SiGNAT— RE OF P �L'L T-FEE OR DESIGNEE)
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By this sigrat,r-re, [ cert .fy that this report i< accurate
g C,E:.Pv-1-6<.AL FILES complete to the best of my know;edge-
Part .A: Spe�ic Moriferng Requirements ; j\NR 3EC"TlO,+
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STORM EvEN`F CHARACTERISTICS:
Date
Total Event Preripitatian (inches):
Event Duration (hours): (oaiy if arpl_'cab?c - sce
(-f r,ore •!;, cnc stc m cvsct was saapicc;
Date
Total Event Precipitation (iuches):
Event Dura6oa (o—iv 4 appscab:e - see
;Mail Original and one copy to:
A LC: CcC: --7ai miles
16 i i Maw Ss vicc Ccr. r
F2alcigL. ' a=- C'.arol;na 2 6SS-:5 i
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"I certify, under penalty of law, that this dacameat apd all attachments were prepared under my directiaa ar supervision in accordance with a
system designed W assure tE2: quaii�ed petsonaeI pmpc -!y gather and evaluate 14e in;orrmatzoa submitted. Based as n; inq :ir-y' of the person
or persons wfro manage the system, or those persons directly nesooasible for gathet-Lag the iafatxadoe, the iaro:ma'an submit-ted is.:a the best
of my imowiedge and belief; true, accurate, acid complete- : am aware that :here are sig ,S icant penflFties for subrnitt:Lng false L-forma-on.
inciudiag the possibiEty of fines and imprisonment for Ernowtng vialations.•'
grature of Perinittee)