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Form 1 Sampling Event Visual Observations and Analytical Results Form 1 – Page 2 of 2 Outfall Analytical Testing: Outfall Name pH (field) Qualified for Representative Sampling Reduction? (Yes / No) Qualified Combined Sample? (Yes / No) Qualified for Sampling Frequency Reduction? (Yes / No) Input below the laboratory analytical result when obtained: Date submitted on SMARTS Likely pollutant source Total suspended solids Oil & grease SW-3 No No No SW-4 No No No Method of pH analysis: Units of measurement: Laboratory method used: Method detection limit: NALs: < 6.0 & > 9.0 Note: Enter NALs for other required analytes per Table 2 of the General Permit. Annual NAL: 100 mg/L Instant: 400 mg/L Annual NAL: 15 mg/L Instant: 25 mg/L Corrective Action Based on Analytical Results: Based on the analytical results of the storm water testing, summarize corrective action needed or taken in the box below. Note if any instantaneous NALs were exceeded. Also, note if any annual NALs are in jeopardy of being exceeded. Don’t forget to submit all sample results on SMARTS within 30 days of receiving them.