NCG190063_DMR_20210810

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR) / SPPP Annual Update DATA REVIEW FORM
Calendar Year 2 o Z /
Individual NPDES Permit No.
Certificate of Coverage (COC) No.
or
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP.
Facility Name: APt--OFn/Taa/ -&4r tlolekS
County: Gt
Phone Number:
- 7 5 23 "r �2 3 % Total no. of SDOs monitored 2-
Outfall No. /
Is this outfall currently in Tier 2 (monitored monthly)?
Was this outfall ever in Tier 2 (monitored monthly) during the past year?
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities?
RECEIVED
DENR-L,ND QUALITY
Yes ❑ No 0" STORmAIATER PERMITPING
Yes ❑ No 0'
Yes ❑ No
Parameter, (units)
Total
Rainfall,
inches
i SS
^''y
t\1 onf , Po/a AZ
j F (e,jgsr
rrh/t
! c �uZ
ini IL
4��, �wM
M1
z i je-
M of It
L J
n4l /L
Benchmark
N/A
/ L J
/ 5
, c r c
7 5-
/ z E
d'1y
Date Sample
Collected,
mmfddfyy
�1
p6
cs,o
;�uZ
2�1�1
Oil
<.cc5
SWU-264 - Generic Annual DMR
Last revised 6/01/2018

Additional Outfall Attachment
Outfall No.
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No '
Was this outfall ever in Tier 2 (monitored monthly) during the past year.? Yes ❑ No
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? YesEl NoEiK
Total
Rainfall,
inches
Parameter, (units)
T55
A7
NCO IV TO /are
"e—z
/4
Atumlww,"
Mf /t-
-Z-1 Wc-
ir
Lr--�
A
Benchmark
N/A
0
-7 5'*
7.50'
Date Sample
Collect
acted
m /yy midd
©
OAS
2-Z o
SWU-264 - Generic Annual DMR
Last revised 610112018

"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
including the possibility/pf
Signature
Date `9
true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
imprisonment for knowing violations."
For questions, contact your local Regional Office:
DEMLR Regional Office Contact Information:
ASHEVILLE REGIONAL OFFICE
FAYETTEVILLE REGIONAL OFFICE
MOORESVH.LE REGIONAL OFFICE
2090 US Highway 70
225 Green Street
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
RALEIGH REGIONAL OFFICE
WASHINGTON REGIONAL OFFICE
_
WILMINGTON REGIONAL OFFICE
3800 Barrett Drive
943 Washington Square Mall
127 Cardinal Drive Extension
Raleigh NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
WINSTON SALEM REGIONAL OFFICE
CENTRAL OFFICE
450 Hanes Mill Rd, Suite 300
1617 Mail Service Center
Winston-Salem, NC 27105i
Raleigh, NC 27699-1617
[phone] 1(919)
807-6300
SWU-264 - Generic Annual DMR
Last revised 8i01/2018