NCS000567_SDO DMR_20210716

STORMWATER DISCHARGE OUTFALL(SDO)
NC Departure MONITORING REPORT
Environmental Qyud.: ,/
Permit Number NCS NCS000567 Received SAMPLES COLLECTED DURING CALENDAR YEAR: 2021
JUL 16 2021 (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.)
Winston-Salem
FACILITY NAME ECOFLO,Inc. Re�ional Of(ic COUNTY Guilford
PERSON COLLECTING SAMPLE(S) Preston Black CERTIFIED PHONE NO.( 336 )617-2714
LABORATORY(S) Pace Analytical Lab# 92545525
Lab#
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Part A: Specific Monitoring Requirements _
Outfall Date 50050
No. Sample Total Total Total PH at 25 BOD, 5 day Lead Chemical
Collected Flow(if app.) Rainfall Suspended degrees Oxygen
Solids Demand
Sample mo/dd/yr MG inches Mg/L Std. Units NIg/L Ug/L Mg/L
001 6/22/2021 N/A .6 10.1 5.1 5.6 ND 20.9
002 6/22/2021 N/A .6 138 5.8 127 22.4 47.3/49.1
003 6/22/2021 N/A .6 51.6 5.4 ND 19.5 48.5
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? yes
(if yes,complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall 1 Date 50050 00556 00530 00400

No. Sample Total Flow Total Oil&Grease Non-polar Total pH New Motor
Collected (if applicable) Rainfall (if appl.) O&G/TPH Suspended Oil Usage
(Method 1664 Solids
SGT-HEM),if
appl.
mo/dd/yr MG inches mg/I mg/I unit gal/mo
Form SWU-247,last revised 6/12/2015
Page 1 of 2
STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Division of Energy Mineral and Land Resources
Date 6/22/2021 Attn: Central Files
Total Event Precipitation(inches): .6 1617 Mail Service Center
Event Duration (hours): 45 Mins (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 imprisonment for knowing violations."
' 1r � 2-1
(Sig ure of Permittee) (Date)
Form SWU-247,last revised 6/12/2015
Page 2 of 2