NCG140339_MONITORING INFO_20190226

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ � �/ / �� v
YYYYMMDD

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — WASTEWATER
SUBMIT TO CENTRAL OFFICE*.
General Permit No. NCG140000
Calendar Year 2019
'Report ALL WASTEWATER monitoring data on this form (include "No RoW`T'No Discharge" and Limit Violations) from
the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG14 ©3❑ 3❑ 9❑
Facility Name: Lowery St.
County: Forsyth
Phone Number: (33.6 ) 226-517 Total no. of outfalls monitored 3
Certified Laboratory Prism Lab Lab # 402
Lab #
Wastewater (WW) Discharge Outfall No. 001
Does this outfall discharge WW to SA waters? Yes ❑ No ❑✓
Does this outfall discharge WW to SB or PNA waters? Yes ❑ No ❑✓
Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No ❑✓
If so, what is the 7Q10 flow rate? or Tidally influenced waters, 7Q10 not available ❑
Does this outfall discharge WW to Trout (Tr) designated waters? Yes ❑ No [Z]
Were there any limit violations in the calendar year? Yes ❑ No ❑✓
Outfall No.
001
Daily Flow Rate,
cfs
pH,
SU
TSS,
mgll
SS,
mill
if applicable
Non-POlar'O&G (EPA Method 1664
(5GT-HEM)), mg/1
Effluent
Limitations
Dolly Maximum
OQW or0RW
50% of 7010
Indicate NO FLOWN
applicable
freshv`eter
6.0-9.0
saltwater
a
6.a-8.5
Standard
30
HOW
20
HQW 1 O PNAand Tr, or
10
HOW, ORIN, SA,
SB,PNA,orany
Trout
a
5
No Limit
Samples above Benchmark
subject to Tiered Responses
15
Date
Sample
Collected,
molddl r
.,
,.
5,
1
1
6C�
3/30/2019
NO FLOW
n
FEB 2019
6/24/2019
NO FLOW
CENTR ,I Ell !*4'
DWR S`=CT1^^?
9/2512019
NO FLOW
12/30/2019
NO FLOW
Permit Date 8t112017 — 6/30/2022
Last Revised 8-22-2017

Certificate of Coverage No. NCG14 ®3❑ 30®
Additional Outfall Attachment (make copies as needed for additional outfalls)
Wastewater (WW) Discharge Outfall No. 2
Does this outfall discharge WW to SA waters?
Yes ❑
No ❑
Does this outfall discharge WW to SB or PNA waters?
Yes ❑
No ❑
Does this outfall discharge WW to HQW or ORW waters?
Yes ❑
No ❑
If so, what is the 7Q10 flow rate? or Tidally influenced
waters,
7Q10 not available ❑
Does this outfall discharge WW to Trout jr) designated waters?
Yes ❑
No ❑
Were there any limit violations in the calendar year?
Yes ❑
No ❑
Outfall No.
002
Daily Flow Rate,
cfs
pH,
SU
TSS,
mgll
SS,
mlll
it applicable
Non -Polar O&G (EPA Method 1664
(SGT-HEM)), mgll
Effluent
Limitations
Daily Maximum
0 OW or ORW
50% of 7Q10
lddleatd NO FLOW ifaaliwaher
applicable
treshwataf
6.0-9.0
6.pp 5
—
v VV
Standard
QI
20
HOW I ORPNand Tr, or
10
HOW, ORW, SA,
se, PNA, or any
Trout
5
No Limit
Samples above Benchmark
subject to Tiared Responses
16
Date�b
Sample
Collected,
moldd! r
;e
.
3/30/2019
NO FLOW
6/24/2019
NO FLOW
9/25/2019
NO FLOW
12/30/2019
NO FLOW
Permit Date 811i2017 - 6/30/2022
Last Revised 8-22-2017

Certificate of Coverage No. NCG14 1 13❑ 9❑
Additional Outfall Attachment (make copies as needed for additional outfalls)
Wastewater (WW) Discharge Outfall No. 3
Does this outfall discharge WW to SA waters? Yes ❑ No ❑
Does this outfall discharge WW to SB or PNA waters? Yes ❑ No ❑
Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No ❑
If so, what is the 7Q10 flow rate? or Tidally influenced waters, 7Q10 not available ❑
Does this outfall discharge WW to Trout (Tr) designated waters? Yes ❑ No ❑
Were there any limit violations in the calendar year? Yes ❑ No ❑
Outfall No.
003
Daily Flow Rate,
cfs
pH,
SU
TSS,
mgll
SS,
mlll
i/dpprkehfB
Non -Polar O&G (EPA Method 1664
(SGT-HEM)), mgll
Effluent
Limitations
Daily Maximum
HQW orORW
50% of 7Q10
Indicate HD FLOW it
applicable
fraehw tar
6.0-9.0
lM
samtsr
6.8-P, C
p 15
Standard
30
HOW
20 20
HOW 1 ORW and Tr, or
1 O
HOW, ORW, SA,
SB,PNA,orany
Trout
�
No Limit
Samples abovo Benchmark
subject to Tlarsd Responses
15
Date
Sample
Collected,
molddl r
�
...• ==3
g
3/3012019
NO FLOW
6/24/2019
NO FLOW
9/25/2019
NO FLOW
12/3012019
NO FLOW
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2017

Certificate of Coverage No. NCG14 ®3❑ 3❑ 99
CERTIFICATION
"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."
tRequired by 40 CFR §122.22] 1 1117
Signature
Date
Mail Annual Summary Wastewater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, INC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2017