NCG140038_DMR SW_20220329

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year 2021
'Report ALL STORMWATER monitoring data on this form (include nNo Flow"PNo Discharge"and Benchmark
Exceedances)from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG14 ] ] 30®
Facility Name: Tri-City
County: Rutherford
Phone Number: 70( 4 )529-6364 Total no. of SDOs monitored 1
Certified Laboratory Waypoint Analytical Lab# 402
Lab#
Stormwater Discharge Outfall (SDO) No. 001 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 0
Yes, received approval from DEMLR to reduce monitoring frequency ID
Other 13
Non-polar O&G
Total (EPA Method New Motor Oil
Total Rainfall, Suspended pH, 1664 SGT-HEM ) Usage (gal/mo.)
Outfall No. inches ( ) '
ao, Solids (TSS), SU mg/l (VMA) If applicable
m /l Ifapplicable
Stormwater Circle Benebmark
Intlicate NO FLOWO 100150 6.0-9.0 15 >55 9a11mo.average ruires T55 and
Benchmarks applicable eqNon-polar O&G monitoring
Date Sample
Collected,
mo/dd/yr
2/17/2021 NO FLOW RECEIVED
3/22/2021 NO FLOW
CEMER6L Ell ES
5/24/2021 NO FLOW I lWR SECTION
9/30/2021 NO FLOW
12/27/2021 NO FLOW
Permit Date 8/1/2017—6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG14 ] ] 3❑®
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. 002 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 ❑
Non-polar O&G
Total (EPA Method New Motor Oil
Outfall No. Total Rainfall, ` "Suspended pH, 1664 (SGT-HEM)), Usage (gal/mo.)
002 inches Solids (TSS), SU mg/I (VMA) llapplicable
mg/I I/applicahle
Stormwater Circle Benchmark
Indxaw NO FLOWir 100150 6.0-9.0 15 >55 gallma.average requires TM and
Benchmarks applicable Non polar O&G monitoring
Date Sample
Collected,
mo/dd/yr
2/1 712021 NO FLOW
3/2 212 0 21 NO FLOW
5124/2021 NO FLOW
9/30/2021 NO FLOW
12/27/2021 NO FLOW
Permit Date 8/1/2017—6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG14 10❑ F8]
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 ❑
Other ❑
Total Non-polar O&G New Motor Oil
Total Rainfall, (EPA Method
Outfall No. Suspended pH, 1664 (SGT-HEM)),
ooa Usage (gal/mo.)
inches Solids (TSS), SU
mg/I mg/I (VMA)
Stormwater Circle Benchmark
Indicate NO FLOW tl >55 gallme.average requires TSS and
Benchmarks applicable 100/50 6.0-9.0 15 NonpolarOSGmanitonng
Date Samplent
Collected,
5124/2021 003 10 5.36 <5.6 OIL AND GREASE
SMW 2540D-2011
12/27/2021 003 29.7 6.75 <6.4 OIL AND GREASE
Permit Date 8/1/2017-6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG14 KRUM
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 info ation, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR§12 22
Signature
Date M ` ti'L
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 811/2017—6/30/2022
Last Revised 8-22-2015