NCG080799_Representative Outfall Status Renewal_20210811

FOR AGENCY USE ONLY
NC
ARO FRO MRO RRO WARO WIRO WSRO
Division of Energy, Mineral, and Land Resources Land Quality Section
Representative Outfall Status (ROS) Renewal Certification Form
Please complete this form if you want to maintain current ROS designations.
Directions: Print or type all entries on this certification form. Attach this form and a copy of the original ROS
approval documentation to the Stormwater Upload Form.
North Carolina General Statute 143-215.66 (i) provides that: Any person who knowingly makes any false
statement, representation, or certification in any application, record, report, plan, or other document filed or
required to be maintained under this Article or a rule implementing this Article ... shall be guilty of a Class 2
misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000).
Under penalty of law, I certify that:
I, as an authorized representative, request renewal of the ROS designations currently granted to the subject
facility.
❑� No site or activity modifications that impact the characteristics of stormwater discharges from the
representative outfalls have occurred at the subject facility.
I am familiar with the information contained in this request and to the best of my knowledge and belief such
information is true, complete, and accurate.
Facilitv Name: City of Greensboro - Hugh Medford Municipal Operations Center
Permit Number: NCG080799
Printed Name of Person Sianiniz: Lorien R. Deaton
Title: Environmental Compliance Specialist
(Signature of Permittee)
8-11-2021
(Date Signed)
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Department of Environmental Quality

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Michael F. Easley, Governor
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State of North Carolina
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William G. Ross, Jr., Secretary
Department of Environment and Natural Resources
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Coleen H. Sullins, Director
Division of Water Quality
May 14, 2008
Mr. Mike Mabe
City of Greensboro
401 Patton Avenue
Greensboro, NC 27406
Subject: NPDES Stormwater Permit
Certificate of Coverage NCG080799
Representative Outfall Status Request
Hugh Medford Municipal Operations Center
Guilford County
Dear Mr. Mabe:
The DWQ Stormwater Permitting Unit staff have reviewed your second request dated March 7,
2008, for a determination that stormwater discharge outfalls from drainage areas A, C, and E be
granted representative outfall status for stormwater outfalls from drainage areas A, B, C, D, and E.
Based on the site map you provided, and on concurrence with your request by DWQ staff from the
Winston-Salem Regional Office after their site inspection, we are granting your request for
representative outfall status. In accordance with 40 CFR §122.21(g)(7), you are authorized to
sample the three outfalls as representative of all five outfalls. This approval is effective with the
next sampling event. Note that General Permit NCG080000 still requires that you perform
Qualitative Monitoring at all five outfalls regardless of representative status.
Please note that any actions you initiate in response to benchmark exceedences as directed in the
tiered response provisions of your permit must address all drainage areas represented by the three
representative outfalls.
Please append this letter to your Stormwater Pollution Prevention Plan (SPPP) to document that
representative outfall status has been approved.
If changes in drainage areas, structures, processes, storage practices, or other activities occur that
significantly alter the basis of this approval, representative outfall status is no longer valid. In that
case, you should resume sampling at all outfalls, or reapply for representative outfall status based
on updated information.
In the event of non-compliance with the permit provisions, or in the event of repeated exceedences
of benchmark values, DWQ may retract our approval of representative outfall status. If you have
any questions or comments concerning this letter, please contact me at [phone], ext. 584
or at [e-mail].
Sincerely,
Ken Pickle
Environmental Engineer
DWQ Stormwater Permitting Unit
cc: Corey Basinger, Winston-Salem Regional Office
Stormwater Permitting Unit file NCG080799
DWQ Central Files
NorthCarolina
Naturally
North Carolina Division of Water Quality 1617 Mail Service CenterRaleigh, NC 27699-1617 Phone [phone] Customer Service
Internet: www.ncwaterquality.org Location: 512 N. Salisbury St. Raleigh, NC 27604 Fax [phone]
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