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Stormwater Monitoring Reuuirements: <br />Visual Monitoring, Part 1.1.1 <br />The permittee must conduct all required monitoring on a storm or snowmelt event that results in an actual discharge from the facility ('measurable storm <br />event'), which includes discharges to surface water within the facility permit boundary, and that follows the recedin measurable storm event by at least <br />72 hours (3 days), <br />Permittee must collect a stormwater sample from each outfall listed below and conduct a visual assessment of each of these samples 4 times annually <br />Quarterl . Samples must be collected in a clean clear container (plastic or class) in a manner that the samples are representative of the stormwater <br />discharge. <br />Defined Discharge Outfall(s) Discharge Outfall(s) Description Receiving Stream <br />Outfalf s to surface Water Lat, Lon <br />Outfall Number 39.761281, Stomawater runoff West Douglas Creek <br />001-A-108.788275 Douglas Creek <br />1. Has the facility been inactive and unstaffed, and there is a signed statement (see glossary) in the SWMP ? <br />❑ Yes (if yes indicate "General Permit Exception' on the quarterly DMRs) 0 No (if no continue to question 2) <br />2, Did a discharge occur during the reporting period? ❑ Yes (if yes continue to question 3) N No (if no indicate "No Discharge") <br />3. Date: Time: Signature of individual performing collection and assessment: <br />4. Type of discharge? ❑ Snowmelt ❑ Runoff (rain event) <br />5. Duration (in hours) of the rainfall or snowmelt event: . Magnitude (in inches) of the storm event sampled: <br />6. Was sample(s) taken within the first 30 minutes of discharge? ❑ Yes ❑ No (provide explanation ) <br />7. Were any of the following water quality characteristics observed? <br />Characteristic <br />Color <br />Odor <br />Floating Solids <br />Settled Solids <br />Suspended Solids <br />Foam <br />Oil Sheen <br />Other Indicators of <br />Pollution <br />U Yes <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />0 Yes <br />Probable source if observed contamination I Corrective Action Taken <br />B. Include document of visual assessment observations within the facility SWMP as required in Part I.M.8 of the permit. <br />1 certify that this report is true, accurate, and complete, to the best of my knowledge and belief. <br />Page 3 of 5 <br />