NCS000373_COMPLETE FILE - HISTORICAL_20190205

STORMWATER DIVISION CODING SHEET
RESCISSIONS .
PERMIT NO.
�✓ l�S � O D.
DOC TYPE
COMPLETE FILE =HISTORICAL
DATE OF
.RESCISSION
YYYYMMDD

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS 000373
FACILITY NAME _Michelin Aircraft Tire Company
PERSON COLLECTING SAMPLE(S) Heather Ashby
CERTIFIED LABORATORV(S) _Pace Analytical Lab #t_PASI-C_
Pace Analytical Lab # PASI-A
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: _2018
(This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
COUNTY Stanly
PHONE NO. (_704_) 474-8136
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Outfall
Date
50050
—
I Z
No.
Sample
Collected
Total
Flow if app.)
Total
Rainfall
Oil & Grease
pH
COD
mo/dd/ r
MG
inches
M /l
Std. Units
M /I
SDO #1
12/20/18
0.33
ND
6.54
ND
SDO #2
12/20/18
0.33
ND
5.6
38
REE
CD V v
SECTION
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _X_no
(if yes. complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total
Rainfall
Oil & Grease
(if appl.)
Non -polar
O&G/TPH
(Method 1664
SGT-HEM), if
appl.
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/ddl r
MG
inches
m /l
m /l
unit
al/mo
Form SWU-247, lust revised 21212012
Pa-e 1 of 2

STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Division of Water Quality
Date _09/10/18 Attn: Central Files
Total Event Precipitation (inches): `0.33 1617 Mail Service Center
Event Duration (hours): (only if applicable — see permit.) Raleigh, North Carolina 27699-1617
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
"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 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 imlprisonment for knowing violations."
(Signature
IR311?
(Date)
Form SWU-247, last revised 21212012
Page 2 of 2