NCS000087_MONITORING INFO_20140131

-- STORMWATER-DIVISION-CODING-SHEET
PERMIT NO.
DOC TYPE
❑ FINAL PERMIT
MONITORING INFO
❑ APPLICATION
❑ COMPLIANCE
❑ OTHER
DOC DATE
❑ D-Ui ` (J-l31
YYYYM M DD

STORMWA rER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS 000087
FACILITY NAME ee,4 01'r 4qua IC Sygferns _
PFRSON COL#_F.•CTIN(; Sa,N11'I,F(S) �rar1C� Gi�rdirlc�
CERTIFIEDLABORAT.ORY(S) Pace 4,7alvtrca! Lab#
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: ZO I'l
(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 L- ee
PHONE NO. 319) Culp - 8260
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
SIGNATURE
Date
Sample
Collected
I! !
i
Flow (if app.)'
I
IL'1►�1>EI<111L'�
i
•
.
•
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
yes _no
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(ifapplicable)
Total
Rainfall
Oil & Grease
(ifappl.)
Non -polar
O&G/TPH
(Methed 1664
SGT-HF-M), if
appl.
Total
Suspended
Solids
pH
New Motor
Oil L=saae
mo/dd/vr
MG--
inches
MEA
m
'unit
al/mo
Form SWU--247- Inst revised 1/2,2012
Paee ]'of 2

STORM EVENT CHARACTERISTICS:
Date l- l0- 14
Total Event Precipitation (inches): i
Event Duration (hours): (only ifapplicable—seepermit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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 assur"e 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. 1 am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations."
—:�s ( , -
, '4�� 1 23 t4
(Signature of Permi ee) (Date
Form SWU-237.. lust revised 2;2i2U12
Page 2 of ?

i
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS 0000a7SAMPLES COLLECTED DURING CALENDAR YEAR: 20
(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.)
FACILITY NAME Fe, 4,yL, wfic safe,ns • R �_ECEIVED COUNTY Lee
PERSON COLLECTING SAMPLES) iS G tr7a JUL 0 3 2013 PHONE NO. L914 }' 5&& - 2Z&0
CERTIFIED LABORATORY(S) peace 101VtiC611 Lab #
Lab #CENTRAL FILES
DWQfBW SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Part A: Specific Monitoring Requirements
I I
1
1:
•1mmm-
II i
I
i
i
Does
Part B: Vehicle Maintenance Activitv Monitoring Requirements
Ootfall
No.;
:
Date :
S
Collected
50051?,;-
" :
00556
'00530 ' .
00400, "
Total Flow
(if applicable)
Total
Rainfall
Oil &Grease
(if appl.)
Nan -polar
O&G/TPH
(Method 1664
SGT-HEM), if
appl.
Total
Suspended
Solids
pH
New Motor
Oil Usage
=
inoldd/ r
MG...,-,,,,,
inches , :
m _
inunit
al/nm
Form S WU-247, last revised 21212012
Pagel of 2

r
t�
STORM EVENT CHARACTERISTICS:
Date 5 ZO f3
Total Event Precipitation (inches): i
Event Duration (hours): (only if applicable —see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable —see permit.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with i
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."
Co I
L-3if3
(Date)
Form S WU-247, Iasi revised•2/2/2012
Page 2 of 2