NCG140208_DMR WW_20220329

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — WASTEWATER
II SUBMIT TO CENTRAL OFFICE* II
General Permit No. NCG140000
Calendar Year 2021
*Report ALL WASTEWATER monitoring data on this form (include "No FloW'/ No Discharge" and Limit Violations) from
the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG14 U 2�
Facility Name: Statesville
County: Iredell
Phone Number: 7( 04 ) 529-6364
Certified Laboratory Waypoint Analytical
Lab #
Lab #
Total no. of outfalls monitored 1
Wastewater (WW) Discharge Outfall No. 001
Does this outfall discharge WW to SA waters? Yes ❑ No ❑✓
Does this outfall discharge WW to SB or PNA waters? Yes ❑ No ❑✓
Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No ❑✓
If so, what is the 7Q10 flow rate? or Tidally influenced waters, 70110 not available ❑
Does this outfall discharge WW to Trout (Tr) designated waters? Yes ❑ No ❑✓
Were there any limit violations in the calendar year? Yes ❑ No ❑✓
Outfall No.
Daily Flow Rate,
pH,
TSS,
SS,
Non -Polar O&G (EPA Method 1664
cfs
SU
mg/I
ml/I
(SGT-HEM)), mg/I
007
dapplicable
Standard
Effluent
oQWorQRW
50%of7Q10
fresbwater
6.0-9.0
30
HQW, QRW,SA,
No Limit
Limitations
HQW
2U
SR. PNA, or any
Trout
Indicate Ncable
5
Samples above
applicable
O O
6.6-$ 5
HQW IOPNand Tr, or
Responses
sublet! to Tleretl R¢sponsea
Daily Maximum
.8-8.
15
10
DateSample
may_
as
Collected
mo/dd/yr
t�
r
2/9/2021
001
7.49
22
oil and grease <5.2
SM 2540 D- 2015
6/15/2021
NO FLOW
_
RECPIt
8/23/2021
NO FLOW
12/10/2021
NO FLOW
CENTRAL
FILES
12/20/2021
NO FLOW
WR SEC
TION
DWR
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2017

Certificate of Coverage No. NCG14 KIF2Q91E]
CERTIFICATION
" 1 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 § 9 R2.2
Signature
Date
V-
Mail Annual Summary Wastewater 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 8/1/2017 — 6/30/2022
Last Revised 8-22-2017