NCG020895_DMR_20210205

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
II SUBMIT TO CENTRAL OFFICE* II
General Permit No. NCG020000
Calendar Year 10a O
*Report ALL STORMWATER monitoring data on this form (include "No Flow"!"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG020895 �
Facility Narrlte: A LLr e—� I oLn S p r I n 5 S 1 Y/1', n -e
County:
Phone Number: ( iscxl ) -7al-'1319- Total no. of SDOs monitored
Certified Laboratory Njf) Lab #
Lab #
Stormwater Discharge Outfall (SDO) No. N A VMA Outfall?
Yes ❑
No ❑
Is this outfall currently in Tier 2 for any parameter?
Yes ❑
No ❑
Was this outfall ever in Tier 2 during the past year?
Yes ❑
No ❑
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
RECF I\/F D
Yes, enough consecutive samples below benchmarks to decrease frequency
❑
Yes, received approval from DEMLR to reduce monitoring frequency
❑
FPP i 5 2021
No, turbidity benchmark exceedances did not require monthly monitoring
❑
CENTRAL FILES
Other
❑
DWR SECTION
Outfall No.
Total
Rainfall,
inches
TSS,
mg/I
SS,
mill
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mg/1
(VMA)
New
Motor Oil
Usage
al/mo.
Stormwater
Benchmarks
Indicate NO
aFLO abl
01Ge
Benchmark
100/50
0.1
`Irel`
BenC=.,k
50/25/10
N/A
sta�ea.a applies
N/A
5� dad aPp ies
p
1
'55 gagmo.
average requires
TOaG monitoringo
Date Sample
Collected,
mo/dd/yr
Permit Date 5/31 /17 - 9/30/2020
Revised 5131117 for Additional Monitoring Specific to this COC

Certificate of Coverage No. NCG020895
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."
[Required by 40 CFR §122.22]
Signe
Date
Mail Annual Summary Stormwater 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)
DWR Central Files
512 N. Salisbury St.
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 5/31/17 — 9130/2020
Revised 5131117 for Additional Monitoring Specific to this COC