NCS000546 DMR SW (Signature Page)

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 Activitv Monitoring Reauirementc
Outfall Date
No. Sample
Collected`
50050
00556
00530
00400
Total Flow
(if applicable) JRainfall
Total
`
Oil &-Grease
"(if appl.)
Non -polar""
O&G/TPH
Method 1664
-Total
Suspended
-Solids
pH
New Motor
-Oil Usage
SGT -HEM), if
appl.
mo/dd/ r
MG
,inches
mg/1
mg/1
unit
al/mo
Notes: Exceedances include Zinc at SW020 and Mercury at SW016. SW016 failed MS/MSD for Hg at 58/50% (acceptable recovery is 71-125%).
STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Division of Water Quality
Date 7/21/2016 Attn: Central Files
Total Event Precipitation (inches): 0.24 1617 Mail Service Center
Event Duration (hours): NA (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."
_ '?" �� I
(Date)
NCS000546 Form SWU-247, last revised 2/2/2012
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