NCG020267_DMR_20210216

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year a.,/d-0
'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. NCG02 ©❑0©Q
Facility Name: S i�l`t Ntle �` CU
County: Gee°
Phone Number: ?,W 27d - z/1.13 Total no. of SDi monitored 3
Certified Laboratory Al"ruwt Lab # -11%
Lab #
Stormwater Discharge Outfall (SDO) No. i VMA Outfall? Yes ❑ No p�
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No 0'
Was this outfall ever in Tier 2 during the past year? Yes ❑ No D� If this outfall was in Tier 2 last year, was monthly monitoring discontinued? RECEIVED
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑ MAR 01 2021
No, turbidity benchmark exceedances did not require monthly monitoring ❑ CENTRAL FILES
Other ❑ C)WR SECTION
Outfall No.
Total
Rainfall,
inches
TSS,
mg/1
SS,
ml/l
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mg/I
(VMA)
New
Motor Oil
Usage
(gal/mo.)
Stormwater
Benchmarks
InFLOWNO
FLOWII
applicable
G""°
Benchmark
100/50
0.1
ncns
Benchmark
50/25/10
N/A
standard apples
N/A
standard applWater ies
15
.gore55 mo.
avenge requires
TO&G m SS andNon
oring
Date Sample
Collected,
mo/dd/yr
9/3l/ a0
d//o
a.99y
!r :'
cl.)N
5,77E
I
a.�9
Permit Date 10/1/2015 - 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ❑o ®©❑7
Additional Outfall Attachment (make copies as needed for additional ouffalls)
Stormwater Discharge Outfall (SDO) No. oL 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 ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other
Outfall No.
Total
Rainfall,
inches
TSS,
mg/I
SS
ml/I
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mg/I
(VMA)
New
Motor Oil
Usage
al/mo.
Stormwater
Benchmarks
Indfcafe NO
.,',Ow'
a ft.ble
Benchmark l.
Benchmark
100150
0.1
Benchmark
`hnn
50/25/10
N/A
standard appliater Qu es
N/A
Standard applies
15
aeara a°re uires
9 9
TOSG m SS andnif �nlar
Date Sample
Collected,
mo/dd/yr
3 /31 / 2,v
111e,
{87
s f
� .
4P. I
F
! fJ
/ 20
is
6,G67
moo. f
G/. 7
Permit Date 10/112015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ©1❑®0
Additional Outfall Attachment (make copies as needed for additional outfalls)
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
❑
No, turbidity benchmark exceedances did not require monthly monitoring
Other
n
Outfall No.
3
Total
Rainfall,
inches
TSS,
mg/I
SS,
ml/I
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mg/I
(VMA)
New
Motor Oil
Usage
(gal/mo.
Stormwater
Benchmarks
Mdlcare NO
,F` k;;;°
Q hin
Benchmark
100/50
0.1
°1Ge
Benchmark
50/25/10
N/A
Standard app sass
N/A
Standard ppli s
15
avarege ilino
era a mquires
SS and
TOBG Monitoring
Date Sample
Collected,
mo/dd/yr
3/31 /av
gird
G3.3t1-1
N
Permit Date 101112015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ® Mot FAH]
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 §122.221
Signature )-Z7Ai6 —OZ
Date J / 14/ a I
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in D WR (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 10/112015 — 9/30/2020
Last Revised 10-2-2015