NCG140478 DMR SW 20201223

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year 2020
*Report ALL STORMWATER monitoring data on this form (include "No Flow"P'No Discharge' and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG14
Facility Name: LANE TEMPORARY CONCRETE PLANT-STATESVILLE
County: IREDELL
Phone Number: 336 ) 618-4671
Certified Laboratory Statesville Analytical
Lab # DW 37755
122 Court St, Statesville NC, 28687 Lab #
Total no. of SDOs monitored 1
Stormwater Discharge Outfall (SDO) No. ° 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?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Outfall No.
Total Rainfall,
inches
Total
Suspended
Solids (TSS),
mg/I
pH,
SU
Non -polar O&G
(EPA Method
1664 SGT-HEM
( ))'
mg/I (VMA)
I/applicable
New Motor Oil
Usage (gal/mo.)
/(applicable
Stormwater
Benchmarks
Indicate NO FLOW iI
r=aU1e
Ci enchnnark
10 50
6.0-9.0
15
>55 gallmo. average requires T55 and
Non -polaro&G monitoring
Date Sample
Collected,
mo/dd/yr
'
12/14/2020
24
32
8,15
N/A
N/A
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG14 ]K] 7❑®
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]
Signature Kevin J. Sifford.
Date 12123/2020
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)
Division of Water Resources
Attn: DWR Central Files
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 8/1/2017 — 6/30/2022
Last Revised 8-22-2015

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out thisform, please visit: htM://por-tal.ncdenr.org/web/Ir/ni2des-stormwater/
Permit No.: N/�/_/_/_/_/_/_/_/ or Certificate of Coverage No.:
Facility Name: Temporary Cancade Batch Plant Statesville
County: Inedell Phone No. 336-5184671
Inspector: David Chapano
Date of Inspection: 12/14/2020
Time of Inspection: 12:30 PM
Total Event Precipitation (inches): 2_41
Was this a "Representative Storm Event" or "Measureable Storm Event" RED 44 rmit?
(See information below.)
JAN 2 5 2021
K Yes ❑ No �,EiJ i;"•! r1Lu'c
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
! Qualitative monitoring requirements vary.-Most-permits-
ary. Mastpermits require qualitative monitoring to be j
performed during a "representative storm event" or during a "measureable storm event" However,
i
some permits do not have this requirement. Please refer to these definitions, if applicable.
I
I A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the i
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office_ J
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
David M. Chapa
(Signature of Permittee or Designee)
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SWn-242, Last modified 7/31/2013

1. Outfall Description:
Outfall No. ' Structure (pipe, ditch, etc.) ocs
RPrPiuinQStrPam. Fourth Creek
Describe the industrial activities that occur within the outfall drainage area:
Light Concrete Producgon on Limited Daily Basis
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Clear -Natural
3, Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): None
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is
clear and 5 is very cloudy:
0 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
01 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
7.
91
1 Q2 3
Is there any foam in the stormwater discharge?
4 5
Yes Oo
Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe None
M
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 7/31/2013