NCG020267_Statesville Brick Monitoring_20220215

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR) / SPPP Annual Update DATA REVIEW FORM
Calendar Year JOal
Individual NPDES Permit No. NCS❑❑❑❑❑❑ or
Certificate of Coverage (COC) No. NCG©® o❑®© 7❑
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP.
Facility Name:
County: L'e-de.I t v A
N 6C
Phone Number: (7�f) Total no. of SDOs monitored lo?
Outfall No. Z `Q
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No Er r
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No a m
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? Yes ❑ No 0�
Parameter, (units)
Total
Rainfall,
Inches
/t / /L
i
Benchmark
N/A
Date Sample;,
Collected
mm/dd/yy '
CO S0
IVIO 1
3/ro".31
4/A
SWU-264 - Generic Annual DMR
Last revised 5/02/2018

I_�:Clfi[.TiF1N7ifii;7ll_{iF7.7�TiT7'iii
Outfall No. a%
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
❑
o `n
Received approval from DWQ to reduce monitoring frequency
ElN'a
Other
❑
AQZpo c�3
Was this SDO monitored because of vehicle maintenance activities?
Yes ❑ No
p
Parameter, (units)
Total
Rainfall,
inches
f f
Ml/L
%lS
MO/L
7v,btd/�y
N1t/
Benchmark
Date Sample
Collected,
mm/dd/yy
N/A
Le.i
3.tr�
6.Ga
7.-27
SWU-264 - Generic Annual DMR
Last revised 5/022018

Additional Outfall Attachment
Outfall No. S
Is this outfall currently in Tier 2 (monitored monthly)?
Yes ❑ No ff'
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
❑
<T
Other
❑
�d
Was this SDO monitored because of vehicle maintenance activities?
Yes ❑ No
(units)
M
TotalParameter,
Rainfal
inches
-�-
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SWU-264 - Generic Annual DMR
Last revised 510MOI S

" 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."
Date 9_ - / O - Z Z.
For questions, contact your local Regional Office:
DWQ Regional Office Contact Information:
ASHEVILLE REGIONAL OF]
2090 US Highway 70
Swannanoa, NC 28778
[phone]
RALEIG11 REGIONAL OFFICE
3800 Barrett Drive
Raleigh, NC 27609
[phone]
ISTON-SALEDI REGIONAL OR
450 Hanes Mill Rd, Suite 300
Winston-Salem, NC 27105
[phone]
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301-5043
[phone]
943 Washington Square Mall
Washington, NC 27889
[phone]
CENTRAL OFFICE
1617 Mail Service Center
Raleigh, NC 27699-1617
[phone]
610 East Center Avenue/Suite 301
Mooresville, NC 28115
[phone]
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
7o preserve protect
and enhance
Nodh Carolina^s6valer-
SWU-264 - Generic Annual DMR
Last revised 5/02/2018